Figure Legends
Figure 1
Angiographic evidence of a significant stenosis in the mid-RCA.
Figure 2
(a) A balloon-induced dissection in the distal part of the lesion with
some luminal thrombus and an eccentric calcific plaque is evident in the
cross-section. (b) In the mid-segment of the RCA the cross-section shows
a calcific plaque extended to more than 2 quadrants (arrows heads). (c)
Healthy coronary segment in the proximal landing zone.
Figure 3
Predilation with a 3.0 mm non-compliant balloon checked in two
orthogonal angiographic views showing good expansion of the ballon.
Figure 4
3.0 x 25 mm sirolimus-eluting BRS deployment (a) optimized with a 3.5
x12 mm non-compliant balloon expanded at 18 atm (b) with a good
angiographic result (c).
Figure 5
The OCT pullback after BRS implantation shows a large dissection at the
distal edge (a) and well expanded BRS with fully apposed struts in the
mid-segment (b).
Figure 6
Angiography shows the second BRS lost in the proximal segment (red
circle indicating one of the markers of the dislodged BRS). Red arrows
show the markers of the deployed BRS.
Figure 7
Angiographic still frames show the 3.5 x 26 mm DES implanted within the
dislodged BRS in the proximal segment (a) and the 3.0 x 18 mm DES
deployed distally to the previous BRS (b) with good final angiographic
result (c).
Figure 8
Final OCT pullback. (a) The cross-section shows good apposition of the
DES struts in the distal part covering the dissected segment. (b) Good
expansion and apposition of the BRS struts. (c) Short BRS-DES overlap.
(d) DES struts well apposed to the vessel wall proximally to the overlap
zone with the BRS. (e) DES expanded inside the “lost” BRS with a good
expansion of both devices. (f) Non significant malapposition of the DES
struts at the proximal edge level.
Figure 9
Angiographic view of the RCA at 9-months follow-up.
Figure 10
Complete endothelialization of the distal DES struts. (b) Good MLA
with evidence of an advanced reabsorption process of the BRS with
black boxes still visible (white arrows) in the context of the
neo-intima and well separated by the media (arrow heads). (c) The
stent struts rendering function of the co-registration identifies the
DES metallic struts only. (d) The cross-section highlights the BRS
black boxes (arrow head) “covered” by the DES metallic struts (white
arrow). (e) Acquired malapposition of the proximal DES at the proximal
edge level. (f) OCT long view showing good lumen profile and MSA.