CASE 3
A 62-year-old male, with a history of a NSTEMI 7 years earlier requiring treatment of the proximal LAD using a DES, underwent primary angioplasty for anterior STEMI due to very late LAD ST. After pre-dilatation with a 2.0 mm SC balloon and administration of intracoronary eptifibatide, a 3.5 mm DES (Xience Sierra, Abbott Vascular) was implanted at nominal pressure, which immediately re-established TIMI 3 flow. Four days later OCT guided stent optimization was performed using a 3.5 mm OPN NC balloon at 40 atm to correct under-expansion and 4.0 mm SC balloon at 16 atm to optimize apposition. His follow-up remained uneventful and he recovered well. Of note, his latest LVEF was 55% with mild anterior hypokinesia.