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Combined intracoronary 2D–3D optical coherence tomography and intravascular ultrasound imaging in left main severe stent malapposition

  • Enrico CerratoEmail author
  • Corina Biagioni
  • Pilar Jimenez-Quevedo
  • Ivan J. Nuñez-Gil
  • Nieves Gonzalo
  • Javier Escaned
Images in Cardiovascular Intervention
  • 162 Downloads
A 65-year-old woman was previously treated with drug eluting stent (Resolute 3.5/12 mm Medtronic, Minneapolis, MN, USA) implantation in ostial LM with a satisfactory final result at optical coherence tomography (OCT) imaging (Fig.  1A). Six months later she was admitted because of unstable angina and coronary angiograms revealed a severe de novo mid left anterior descending (LAD) stenosis (Fig.  1B). Unexpectedly, after wiring the LAD stenosis with a 0.014’’ floppy wire, the stent was unable to progress through the LM to the distal lumen. OCT imaging revealed that the wire had entered the LM between the struts and the vessel wall (area of stent malapposition), finally re-entering the stent luminal area (Fig.  1C–E). The OCT 3D reconstruction clearly depicted this scenario (Fig.  1E*). To gain access to the true stent lumen, an IVUS probe was advanced to guide LM re-wiring showing a severe LM stent compression with an MLA of 4.3 mm 2 (Fig.  1E***). To stabilize the coaxial system, facilitate...

Notes

Compliance with ethical standards

Conflict of interest

Dr. Javier Escaned has served as board member in advisory board meetings organized by Boston Scientific and served as speakers at educational events organized by St. Jude Medical. The other authors do not report any conflict of interest.

Supplementary material

Supplementary material 1 (AVI 3480 kb)

Supplementary material 2 (AVI 4915 kb)

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Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2017

Authors and Affiliations

  • Enrico Cerrato
    • 1
    • 2
    Email author
  • Corina Biagioni
    • 1
  • Pilar Jimenez-Quevedo
    • 1
  • Ivan J. Nuñez-Gil
    • 1
  • Nieves Gonzalo
    • 1
  • Javier Escaned
    • 1
  1. 1.Interventional CardiologyHospital Clinico San CarlosMadridSpain
  2. 2.San Luigi Gonzaga University Hospital, Orbassano and Infermi HospitalRivoliItaly

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