Author + information
- Received July 8, 2012
- Revision received August 20, 2012
- Accepted August 31, 2012
- Published online March 1, 2013.
- Kensuke Takagi, MD⁎,†,‡,
- Tadayuki Yakushiij, MD§∥,
- Sandeep Basavarajaiah, MD⁎,†,
- Alaide Chieffo, MD⁎,
- Tasuku Hasegawa, MD⁎,† and
- Antonio Colombo, MD⁎,†,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Antonio Colombo, Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, 48 Via M. Buonarroti, 20145 Milan, Italy
A 43-year-old man presented with crescendo angina. Coronary angiography demonstrated ambiguous stenosis of ostial left main stem (LM) (Figs. 1A and 1B). After pre-dilation, a 4.0/12 mm Everolimus-eluting stent (Xience Prime, Abbott Vascular, Santa Clara, California) was deployed in the ostium of LM. Intravascular ultrasound (IVUS) post-stenting showed minimum cross-sectional area of 8.5 mm2 (Fig. 2B-2). High-pressure (24-atm) post-dilation was performed with a 4.0/8.0 mm noncompliant balloon to flare the stent struts (Figs. 1C and 1D). An IVUS demonstrated adequate stent expansion in the post-dilated segment. However, the distal segment of stent appeared compressed and deformed with minimum cross-sectional area of 7.5 mm2 (Fig. 2C-2).
This is the first case to report the occurrence of acute “recoil” phenomenon of a stent probably because of aggressive post-dilation in the proximal segment of the stent. To further evaluate this phenomenon, we performed bench testing on MultiLink stent (Guidant/Advanced Cardiovascular Systems, Santa Clara, California) in a 3.0 mm tube with IVUS assessment. The 3.0 mm MultiLink stent was post-dilated with a 4.0/8.0 mm noncompliant balloon at 24 atm in the proximal segment. The stent exhibited acute recoil phenomenon in the segment distal to post-dilation (Fig. 3). In view of our findings, it reinforces the message that IVUS guidance is extremely vital in LM stenting to achieve optimal results (1).
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received July 8, 2012.
- Revision received August 20, 2012.
- Accepted August 31, 2012.
- American College of Cardiology Foundation