Unconventional treatment of aorto-ostial instent restenosis with marked protrusion into the aorta.

We report a case of restenosis following ostial stenting of the right coronary artery, with protrusion of the stent into the aorta. Despite multiple attempts, no wire could be advanced coaxially inside the stent. The solution was to pass a wire through the struts of the protruding stent and crush it using progressively larger balloons and, finally, a drug-eluting stent was expanded to high pressure. The highlight of this case report is the final intravascular ultrasound image, revealing the profound deformation of the previous stent to restore a large ostial lumen and regain vessel access.