Inter-lacing OF STENTS: 13-MONTH FOLLOW-UP BY INTRAVASCULAR ULTRASOUND AFTER PRIMARY SIMULTANEOUS KISSING STENTING

Abstract

A fifty-four-year old man suffered from ST-segment elevation myocardial infarction of Killip class I over the anterior wall. The emergent coronary angiogram showed true bifurcation lesion of Duke type D over the mid-LAD and 2(nd) diagonal branch. The stenting strategy was made more difficult by discrepant diameters of the mid and distal LAD, which hampered cullote- or T-stenting technique. Simultaneous kissing stenting was successfully performed in the scenario of acute myocardial infarction. Angiographic follow-up showed minimal in-stent restenosis of both stents. Interestingly , the IVUS disclosed that the "double-barrel" portion of the stents had become inter-laced, not in the expected pattern of "back-to-back". The interesting picture could be explained by double-helix configuration of the double-barrel portion of the stents, and the innate inward driving- force originating from negative remodeling of the accommodating vessel.