Provisional side branch stenting: Presentation of an automated method allowing online 3D OCT guidance

摘要

A 58-year-old man with unstable angina underwent percutaneous coronary intervention for a severe stenosis of the mid-left anterior descending artery (LAD), at a bifurcation point with a large diameter diagonal side branch (SB). After predilation with an Emerge 3.0 x 12 mm balloon (Boston Scientific, MA, USA), a 3.0 x 32 mm Promus Element (Boston Scientific) everolimus-eluting stent was implanted in the LAD. Subsequently, proximal post-dilation with a non-compliant (NC) Quantum 3.75 x 8 mm balloon (Boston Scientific) and post-dilation of the stent segment with an NC Quantum 3.0 x 12 mm balloon was performed. Then, a second coronary wire was passed through the struts jailing the ostium of the SB and an optical coherence tomography (OCT) pullback (llumien, St Jude Medical, MN, USA) was acquired along the LAD wire. Subsequently, struts were opened towards the ostium of the SB and final kissing balloon post-dilation was performed, followed by a final OCT pullback.