Jailed side branches: Fate of unapposed struts studied with 3D frequency-domain optical coherence tomography

Abstract

We report the case of a 64-year-old man treated for stable angina with two bare-metal stents in the proximal-mid segment of the left anterior descending artery at the bifurcation with the first diagonal and second septal branches without final kissing balloon dilatation. Seven months later he complained of recurrent angina. Frequency-domain optical coherence tomography (OCT) with three-dimensional (3D) reconstruction was performed, showing a thick rim of neointimal proliferation at the ostium of both branches, causing severe restenosis. Deployment of a stent in a bifurcation main branch without opening the struts at the side-branch ostium may facilitate focal restenosis. © 2011 Italian Federation of Cardiology.