The free-metal approach using thrombus aspiration and a drug-coated balloon achieved excellent angiographic results and sustained vessel patency at 6 months in a complex bifurcation lesion.
A free-metal strategy using plaque modification and a drug-coated balloon is a feasible approach for managing complex coronary bifurcation lesions in acute coronary syndrome while preserving side branches.
Absolute Event Rate: 0% vs 0%
We present the case of a 56-year-old male with non-ST elevation myocardial infarction (NSTEMI) and a complex thrombotic lesion at the ostial left circumflex artery (LCX), extending into bifurcating marginal branches. Due to the high risk of side branch occlusion, a stentless strategy using thrombus aspiration, the reverse wire technique, and sequential plaque modification with a cutting balloon (Rodin-CUT technique) was employed. Following optimal lesion preparation, a drug-coated balloon (DCB) was deployed, achieving excellent angiographic and intravascular ultrasound (IVUS) results, with sustained vessel patency at 6-month follow-up. This case highlights the efficacy of a free-metal strategy in managing challenging bifurcation lesions while preserving side branches and avoiding the risks associated with permanent metallic implants.
Gherasie et al. (Thu,) reported a other. The free-metal approach using thrombus aspiration and a drug-coated balloon achieved excellent angiographic results and sustained vessel patency at 6 months in a complex bifurcation lesion.