Instant stent-accentuated three-dimensional optical coherence tomography of a true bifurcation lesion treated with culotte stenting

Abstract

A 65-year-old woman was performed percutaneous coronary intervention for a bifurcation lesion of the left anterior descending artery (LAD) and the first diagonal branch (Dg). After pre-dilatation, the proximal LAD-Dg was stented with the platinum-chromium elevolimus-eluting stent (PtCrEES). After rewiring to LAD, the instant stent-accentuated 3-dimensional optical coherence tomography (iSA3D-OCT) was reconstructed from 2-dimensional OCT (2D-OCT) by ImageJ with self-made macro-program. Classification of overhanging struts in front of the side branch (SB) ostium was the connecting to carina type, and the recrossed wire was confirmed to pass through the large distal cell. After kissing balloon dilatation (KBD), the mid-distal LAD and the proximal-mid LAD were stented with PtCrEESs. After rewiring to Dg, classification of overhanging struts in front of the SB ostium was the free carina type, and the recrossed wire was confirmed to pass through the distal cell, according to iSA3D-OCT. After final KBD, final iSA3D-OCT showed no floating struts.