Stent balloon fracture, endarterectomy, and lithotripsy balloon rupture following percutaneous coronary intervention: A case report

Table 1 Timeline of clinical events from initial presentation to one-month follow-up

Date	Event
Day 0	Initial PCI with coronary stent balloon shaft fracture and stent dislodgement
Day 0 (same day, hours later)	Emergent open-heart surgery with coronary endarterectomy and SVG grafting to mid-LAD
Month 2	Recurrent exertional chest pain; dynamic ECG changes (pseudonormalization → ST depression and T-wave inversion); hs-cTnT elevation; CTA confirms native LAD occlusion at anastomosis with D2/D3 severe stenosis
Month 2 + Day 4	Re-PCI with IVUS guidance; IVL balloon rupture on second pulse cycle; NC balloon achieves calcium fracture; 3 DES implanted; TIMI 3 flow restored
Month 2 + 1 month	One-month follow-up: Symptom-free, adherent to DAPT, ECG stable

PCI: Percutaneous coronary intervention; SVG: Saphenous vein graft; LAD: Left anterior descending artery; ECG: Electrocardiogram; CTA: Computed tomography angiography; TnT: Troponin T; D2: Second diagonal branch; D3: Third diagonal branch; IVUS: Intravascular ultrasound; IVL: Intravascular lithotripsy; NC: Non-compliant; DES: Drug-eluting stent; TIMI: Thrombolysis in myocardial infarction; DAPT: Dual antiplatelet therapy.