Coronary intervention in chronic total occlusion in left main coronary artery.

An 83-year-old man who had undergone coronary aorta bypass graft surgery 25 years ago required treatment for new-onset worsening angina.

Impact of coronary bifurcation angle on the pathogenesis of atherosclerosis and clinical outcome of coronary bifurcation intervention-A scoping review.

Background: A coronary bifurcation stenting is still a challenging issue due to frequent restenosis and stent thrombosis even with drug-eluting stents. The bifurcation angle (BA) between a main vessel and a side branch is one of the crucial determinants of coronary flow and shear stress that affect the plaque distribution. Previous bench and clinical studies have evaluated the impact of the BA between the proximal main vessel and the side branch (Angle A) and the BA between the distal main vessel and the side branch (Angle B) on the clinical outcomes of bifurcation stenting.

Coronary perforation during insertion of a long stent in a severely calcified lesion.

We reported a case that the insertion of a 48-mm-long stent in a calcified coronary lesion after rotational atherectomy led to stent stacking and S-shaped flection, resulting in longitudinal coronary perforation without stent inflation. Its flexibility and length pose a possible risk of deformation inside the vessel during stent insertion.

Feasibility and efficacy of an ultra-short side branch-dedicated balloon in coronary bifurcation stenting.

Background: Side branch (SB) dilation with an ultra-short balloon after main vessel (MV) stenting may minimise stent failure in coronary bifurcation lesions.

Aims: We sought to investigate the feasibility and efficacy of the Glider balloon (GB), a side branch (SB)-dedicated balloon 4 mm in length, in coronary bifurcation stenting.

Methods: In bench testing, stent configuration was examined with micro-focus computed tomography after crossover stenting followed by GB dilation or kissing balloon inflation (KBI).

A case of very late stent thrombosis on the protruded struts at the left main coronary bifurcation.

A previous autopsy study has revealed that malapposed or protruded struts in the coronary bifurcation were a risk factor for very late stent thrombosis (VLST); however, a live clinical case has not yet been reported due to difficulty in observation at the VLST site. In this case, a 56-year-old male patient underwent a zotarolimus-eluting stent implantation in the proximal left anterior descending artery for acute myocardial infarction 3 years previously and had been treated with dual antiplatelet therapy. The patient experienced chest pain and suddenly collapsed due to acute coronary syndrome caused by a huge thrombus in the left main coronary bifurcation.