Combining reverse nano-crush and stentboost technique to optimize outcome for bifurcation stenting

Author(s): Yash Paul Sharma, Prashant Panda, Rajeev Chauhan, Krishna Prasad, Jyothi Vijay

Though provisional stenting is the strategy of choice for bifurcation lesions; many patients need stenting of both main vessel as well as side branch. In order to ensure optimal stent expansion at ostium of side branch as well as reducing the amount of metal struts inside main vessel, reverse nano-crush is an excellent technique. We report a case of a 75 year old male who presented with ST elevation inferior wall myocardial infarction; whose angiography revealed significant disease in left circumflex and obtuse marginal (major) branch. He underwent percutaneous intervention using reverse nano-crush technique along with utilization of stentboost enhancement to ensure adequate stent expansion. The combination of reverse nano-crush with stentboost enhancement can emerge as the strategy of choice for bifurcation lesions; whenever intracoronary imaging is unavailable or not feasible.