The efficacy of excimer laser pretreatment for calcified nodule in acute coronary syndrome

•This is a first study that Excimer laser angioplasty is effective for calcified nodule in ACS patient.•Excimer laser induces not only the debulking of calcified nodule but also thrombus in the culprit lesion.•Finally round shape stent expansion could be obtained without distal embolism.

Stent underexpansion is known as a major cause of restenosis and stent thrombosis in calcified coronary lesions. We report a case of calcified nodule pretreated with excimer laser coronary angioplasty (ELCA) in acute coronary syndrome (ACS). Excimer laser use altered underlying lesion morphology such as calcified nodule and accompanied plaque and thrombus. Pretreatment of ELCA may be a useful tool to get a full expansion of the deployed stent without distal embolism for calcified nodule in ACS.