Optical coherence tomography can be used to visualize the stent accordion phenomenon, a mechanical complication during percutaneous coronary intervention.
May prompt OCT evaluation of ambiguous post-dilatation stenoses; case report leaves open prospective validation of this phenomenon.
Percutaneous coronary intervention (PCI) was done in a 57-year-old male with chronic kidney disease who presented with non-ST segment elevation myocardial infarction. Coronary angiogram showed two vessel disease of the left anterior descending artery (LAD) and the right coronary artery (RCA). The LAD was successfully stented. After predilatation and rotablation, PCI was performed with 2 overlapping drug eluting stents (DES) Promus (Boston Scientific, Marlborough, Massachusetts, USA) 3 mm × 38 mm to the mid RCA and Resolute Onyx 3.5 mm × 34 mm (Medtronic, Minneapolis, Minnesota, USA) to the ostial proximal segment, respectively. After post dilatation using a 3.5 non-compliant balloon, there was a stenotic segment at the ostial area where the stent was implanted (white arrowhead Figures 1,2).
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Cuenza et al. (2017) studied this question.
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