Influence of the sequence of proximal optimisation technique and side branch dilation for the opening of jailed struts after coronary bifurcation stenting
Murasato Y, Mori T, Okamura T et al.

KEYWORDS
proximal optimisation technique; side branch dilation; jailed struts; coronary bifurcation stenting

A 67-year-old man with a 1,1,0 lesion in the left circumflex artery obtuse marginal branch bifurcation (Panel Aa), in which vessel references in the proximal, distal MV and SB were 3.2, 2.6, and 2.8 mm, respectively, underwent zotarolimus-eluting 2.75×12 mm stent (Medtronic, Minneapolis, MN, USA) implantation at 8 atm (Panel Ab). POT was performed with the stent delivery balloon at 12 atm with its distal marker located in the carina to ensure that the stent was well apposed (Panel Ac). A 2.5×4 mm Glider PTCA balloon (TriReme, Pleasanton, CA, USA) was subsequently dilated in the SB ostium (Panel Ad). The procedure was guided with two-dimensional (2D) OCT (St. Jude Medical, St. Paul, MN, USA) and the data were sent to another hospital for 3D reconstruction using dedicated software (INTAGE Realia; CYBERNET, Tokyo, Japan). The 3D image demonstrated GWR into the proximal cell (Panel Ba); however, the protruded struts were folded towards the distal SB after SB dilation (Panel Bb-Bd, Moving image 1, Moving image 2).