Importance of confirmation by instant stent-accentuated three-dimensional optical coherence tomography during bifurcation stenting: far distal rewiring of iSA3D-OCT

An 83-year-old man with effort angina was admitted for percutaneous coronary intervention due to a stenosis in the ostial left anterior descending artery (LAD). After predilatation, the left main LAD was stented with a 3.5×24 mm 2-link biolimus-eluting stent (Nobori™; Terumo, Tokyo, Japan). After proximal optimisation technique and rewiring to the left circumflex artery, the distal rewiring was confirmed by two-dimensional modalities. Instant stent-accentuated three-dimensional optical coherence
tomography (iSA3D-OCT) was reconstructed in about 30 s from OCT (Dragonfly™ JP; St. Jude Medical, St. Paul, MN, USA) by ImageJ v1.47 (National Institutes of Health, Bethesda, MD, USA) with self-made macro programs. According to intraprocedural iSA3D-OCT, the recrossed wire passed through the far distal cell limited the expansion by the link.