Abstract

Plain balloon angioplasty still has a role in small vessel coronary artery disease: A case report

Author(s): Abdelaziz Ahmed Abdelaziz

Coronary Artery Disease (CAD) remains a significant public health issue, with Small Vessel Disease (SVD) representing a challenging subtype. While Percutaneous Coronary Intervention (PCI) with Drug-Eluting Stents (DES) has revolutionized the management of CAD, its role in SVD remains debated, particularly in the context of potential complications like stent thrombosis and restenosis. This case report presents a compelling example where Plain Balloon Angioplasty (PBA) successfully treated a patient with SVD, highlighting its continued relevance in specific clinical scenarios. Patient concerns: A female patient 60 years old, suffered from Insulin-dependent Diabetes Mellitus (DM), Hypertension (HTN), and dyslipidemia and had typical chest pain for the last three months on minimal exertion. The Electrocardiogram (ECG) and Echo revealed ischemic changes and regional wall motion abnormality. Diagnoses: The coronary angiography results revealed multivessel coronary artery disease. Interventions: PCI was done using balloon angioplasty to small-sized vessels (<3 mm in diameter) and DES to Left Anterior Descending Artery (LAD) and Right Coronary Artery (RCA). Then, follow-up angiography was done that showed patent stents and excellent results for balloon angioplasty-treated small vessels. Outcomes: Two years of follow-up of small coronary artery disease vessels treated with PBA were comparable to DES. Conclusion: PBA in small-sized coronary vessels showed a stent-like effect both in immediate and long-term follow-up.