Colegio Argentino de Cardioangiólogos Intervencionistas Revista Argentina de Cardioangiología intervencionista 2250-7531 2313-9307 13 2 2022 06 30 Intracoronary lithotripsy for stent underexpansion resolution: utility of enhanced stent visualization or StentViz™ 0077 0080 EN Juan Mieres Centro CECI. CABA. Argentina jmieres@centroceci.com.ar Carlos Fernández-Pererira Centro CECI. CABA. Argentina Diego Ascarrunz Centro CECI. CABA. Argentina Matías Rodríguez-Granillo Centro CECI. CABA. Argentina Alfredo E Rodríguez Centro CECI. CABA. Argentina Percutaneous coronary intervention is always supported by elements of innovative technologyto create solutions to everyday problems that are complex like the management of severely calcified plaques, and a complication that is sometimes unexpected, which is stent underexpansion that can be truly challenging. We present three cases of stent underexpansion throughout different time periods, the first one presented in an acute form, and was solved within the first 24 hours. The second case was chronic stent underexpansion of several-month evolution that worsened due to the presence of acute coronary syndrome and that was solved in the same hospitalization. The last case was extremely challenging and involved the left main coronary artery that presented a slight stent underexpansion that, within a few months, became symptomatic and was successfully solved. All these cases were solved using intracoronary lithotripsy, a novel device that through ultrasound probes transmitted by a rapid exchange catheter breaks down coronary calcium. These were tested in de novo calcified plaques. We present patients who already had a previous stent and were guided by the stent enhancement technique, General Electric angiography systemStentViz™.It uses an algorithm to visualize the stent struts and allow detailed monitoring to achieve the proper stent expansion, which is associated with fewer cardiovascular events at follow-up. underexpansion of the stent, IVL, intracoronary lithotripsy, StentViz™, ESV, enhanced stent visualization http://www.raci.com.ar/contenido/art.php?recordID=MjIwMg== http://recursos.meducatium.com.ar/contenido/articulos/29000770080_2202/pdf/29000770080.pdf