Role of StentBoost in Successful Guidewire Recrossing

Key words: cardiac imaging, StentBoost

A 42-year-old hypertensive man presented to the emergency department with non-ST segment elevation myocardial infarction. Coronary angiogram revealed thrombotic occlusion of the first obtuse marginal (OM) branch and 70% eccentric stenosis of the proximal segment of left anterior descending (LAD) coronary artery (Figure 1A). He underwent successful percutaneous coronary intervention (PCI), with 2.5 x 28 mm Abluminus stent (Envision Scientific) deployed in the OM and 3.5 x 24 mm Abluminus stent deployed from the distal left main to the proximal LAD (Figure 1B). However, after rewiring of the LAD due to accidental guide disengagement, an attempt to postdilate the stent was unsuccessful, as two non-compliant balloons (4 mm and 3.5 mm) could not cross the stent. At this juncture, StentBoost (Philips Medical Systems) demonstrated abluminal passage of the guidewire through the proximal stent struts (Figure 1C and 1D). The coronary guidewire was removed, rewired and the stent postdilated (Figure 2B) with the same non-compliant balloon (4 x 12 mm) used previously with an excellent end result (Figure 2C) after StentBoost confirmed appropriate intraluminal passage of the coronary guidewire (Figure 2A).

From the Department of Cardiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Disclosure: The authors have completed and returned the ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors report no conflicts of interest regarding the content herein.

The authors report that patient consent was provided for publication of the images used herein.

Manuscript accepted May 1, 2019.

Address for correspondence: Yash Paul Sharma, MD, DM, Professor & Head, Department of Cardiology, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh-160012, India. Email: ypspgi@gmail.com