Author + information
- Received December 24, 2014
- Accepted January 15, 2015
- Published online July 1, 2015.
- Fumiaki Nakao, MD, PhD∗ ()
- ↵∗Reprint requests and correspondence:
Dr. Fumiaki Nakao, Department of Cardiology, Yamaguchi Grand Medical Center, 77 Ohsaki Hofu, Yamaguchi 747-8511, Japan.
Percutaneous coronary intervention was performed on a 60-year-old man for stenoses of the left anterior descending coronary artery (LAD) (Figure 1A). The LAD was stented with 2 biolimus-eluting stents (BES) (Nobori, Terumo, Tokyo, Japan). The left main coronary artery (LM)-LAD was stented with a 2-link 10-crown BES. When followed by rewiring to the left circumflex artery (LCx), the recrossed wire became stuck and was freed by pulling strongly. According to intraprocedural instant stent-accentuated 3-dimensional optical coherence tomography (iSA3D-OCT) (1,2), reconstructed in about 30 s from OCT (Dragonfly JP, St. Jude Medical, St. Paul, Minnesota) and imported to an off-line workstation by freeware ImageJ 1.47v (National Institutes of Health, Bethesda, Maryland) with self-made macroprograms, struts jailing the LCx ostium were pulled up by pulling the wire (Figure 1B, Online Video 1). After kissing balloon dilation (Figure 1C), final iSA3D-OCT showed struts folded on the distal LM (Figure 1D, Online Video 2). Moderate stenosis of the ostial LCx was not stented because of folded struts and floating struts.
Confirmation by intraprocedural iSA3D-OCT is important. Final iSA3D-OCT gives us important information about the selection of strategies for the side-branch lesion.
For supplemental videos, please see the online version of this article.
Dr. Nakao has reported that he has no relationships relevant to the contents of this paper to disclose.
- Received December 24, 2014.
- Accepted January 15, 2015.
- American College of Cardiology Foundation
- Nakao F.