Author + information
- Received December 10, 2013
- Accepted December 20, 2013
- Published online August 1, 2014.
- Katsumasa Sato, MD∗,
- Azeem Latib, MD∗,
- Vasileios F. Panoulas, MD, MRCP, PhD∗,†,
- Toru Naganuma, MD∗,
- Tadashi Miyazaki, MD∗ and
- Antonio Colombo, MD∗∗ ()
- ∗Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy
- †National Heart and Lung Institute, Imperial College, London, United Kingdom
- ↵∗Reprint requests and correspondence:
Dr. Antonio Colombo, EMO-GVM Centro Cuore Columbus, 48 via M. Buonarroti, 20145 Milan, Italy.
This is the first case in the literature describing the V-stenting technique using ABSORB (Abbott Vascular, Santa Clara, California) bioresorbable everolimus-eluting scaffolds (BVS) for the treatment of a left main coronary artery (LMCA) true bifurcation lesion. A 66-year-old woman presented with symptoms of stable angina. A diagnostic angiogram revealed a significant mid-left anterior descending artery (LAD) lesion. After successful implantation of 2 BVS in the mid-LAD, a control angiogram showed haziness extending from distal LMCA into LAD ostium (Medina 0.1.1), likely representing plaque disruption (Fig. 1-I). Due to the fact that the lesions extended in both the LAD and left circumflex artery, we decided to perform V-stenting. A 3.5 × 12-mm BVS (LMCA-LAD) and a 3.5 × 18-mm BVS (LMCA-left circumflex artery) were simultaneously deployed followed by final kissing-balloon inflation. An excellent final angiographic result was achieved (Fig. 1-III). Post-procedural intravascular ultrasound and optical coherence tomography exhibited well-apposed scaffolds with a minimum scaffold area of >6.0 mm² (Figs. 1 and 2⇓). To date, there are no available data in the literature regarding the safety and feasibility of V-stenting using BVS for the treatment of LMCA bifurcation. Unlike the crush or culotte technique, V-stenting does not deform the BVS struts. Furthermore, it allows access to both branches throughout the procedure, without the need to rewire. However, the trade-off for BVS V-stenting is the need for an 8-F guide catheter to allow simultaneous stent deployment, and the procedure is limited to type 0.1.1 bifurcation lesions according to the Medina classification (1). The present case illustrates that V-stenting using BVS is feasible, despite thick (>150 μm) strut scaffolds, and should be considered as 1 of the treatment strategies in appropriate lesions.
All authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received December 10, 2013.
- Accepted December 20, 2013.
- American College of Cardiology Foundation