{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:51:42Z","timestamp":1753876302981,"version":"3.41.2"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T00:00:00Z","timestamp":1685491200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A case of stent thrombosis as a complication of coronary bifurcation stenting is described. We review potential complications of bifurcation stenting and established guidelines.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 64-year-old man presented with a non-ST segment elevation myocardial infarction. High-sensitivity troponin I peaked at 99 000\u2005ng\/L (normal &amp;lt;5). He previously had coronary stenting for stable angina when residing in another country 2 years previously. Coronary angiography revealed no significant stenosis with TIMI 3 flow in all vessels. Cardiac magnetic resonance imaging demonstrated a left anterior descending artery (LAD) territory regional motion abnormality, late gadolinium enhancement consistent with recent infarction, and a left ventricular apical thrombus. Repeat angiography and intravascular ultrasound (IVUS) confirmed bifurcation stenting at the junction of the LAD and second diagonal (D2) with protrusion of several millimetres of the uncrushed proximal segment of the D2 stent in the LAD vessel lumen. There was under-expansion of the LAD stent in the mid-vessel and stent malapposition in the proximal LAD, extending into the distal left main stem coronary artery and involving the ostium of the left circumflex coronary artery. Percutaneous balloon angioplasty was performed along the length of the stent, including an internal crush of the D2 stent. Coronary angiography confirmed a uniform expansion of the stented segments and TIMI 3 flow. Final IVUS confirmed full stent expansion and apposition.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This case highlights the importance of provisional stenting as a default strategy and familiarity with procedural steps in bifurcation stenting. Furthermore, it emphasizes the benefit of intravascular imaging for lesion characterization and stent optimization.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytad259","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T17:59:26Z","timestamp":1685555966000},"source":"Crossref","is-referenced-by-count":0,"title":["Late stent thrombosis as a complication of T and small protrusion bifurcation stenting: a case report"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7220-764X","authenticated-orcid":false,"given":"Gregory","family":"Offiah","sequence":"first","affiliation":[{"name":"Department of Cardiology, Cork University Hospital , Wilton, Cork T12 DC4A , Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"McGrath","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cork University Hospital , Wilton, Cork T12 DC4A , Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Kearney","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cork University Hospital , Wilton, Cork T12 DC4A , Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,5,31]]},"reference":[{"key":"2023061412373351600_ytad259-B1","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1002\/ccd.21314","article-title":"Classification of coronary artery bifurcation lesions and treatments: time for a consensus!","volume":"71","author":"Louvard","year":"2008","journal-title":"Catheter Cardiovasc Interv"},{"key":"2023061412373351600_ytad259-B2","doi-asserted-by":"crossref","first-page":"e008730","DOI":"10.1161\/JAHA.118.008730","article-title":"Single- versus 2-stent strategies for coronary bifurcation lesions: a systematic review and meta-analysis of randomized trials with long-term follow-up","volume":"7","author":"Ford","year":"2018","journal-title":"J Am Heart Assoc"},{"key":"2023061412373351600_ytad259-B3","doi-asserted-by":"crossref","first-page":"e362","DOI":"10.4244\/EIJ-D-22-00165","article-title":"Treatment of coronary bifurcation lesions, part I: implanting the first stent in the provisional pathway. 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The 16th expert consensus document of the European Bifurcation Club","volume":"18","author":"Lassen","year":"2022","journal-title":"EuroIntervention"},{"key":"2023061412373351600_ytad259-B6","doi-asserted-by":"crossref","first-page":"2523","DOI":"10.1093\/eurheartj\/ehaa543","article-title":"Multicentre, randomized comparison of two-stent and provisional stenting techniques in patients with complex coronary bifurcation lesions: the DEFINITION II trial","volume":"41","author":"Zhang","year":"2020","journal-title":"Eur Heart J"},{"key":"2023061412373351600_ytad259-B7","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1016\/j.jcin.2022.04.025","article-title":"Predicted and observed mortality at 10-years in patients with bifurcation lesions in the SYNTAX trial","volume":"15","author":"Ninomiya","year":"2022","journal-title":"JACC Cardiovasc Interv"},{"key":"2023061412373351600_ytad259-B8","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1161\/CIRCINTERVENTIONS.109.868091","article-title":"Double versus single stenting for coronary bifurcation lesions a meta-analysis","volume":"2","author":"Katritsis","year":"2009","journal-title":"Circ Cardiovasc Interv"},{"key":"2023061412373351600_ytad259-B9","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.jcin.2021.11.012","article-title":"Effect of wire jailing at side branch in 1-stent strategy for coronary bifurcation lesions","volume":"15","author":"Choi","year":"2022","journal-title":"JACC Cardiovasc Interv"},{"key":"2023061412373351600_ytad259-B10","doi-asserted-by":"crossref","first-page":"V55","DOI":"10.4244\/EIJV11SVA12","article-title":"IVUS In bifurcation stenting: what have we learned?","volume":"11","author":"Legutko","year":"2015","journal-title":"EuroIntervention"},{"key":"2023061412373351600_ytad259-B11","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1186\/s12872-015-0144-8","article-title":"Comparison of intravascular ultrasound guided versus angiography guided drug eluting stent implantation: a systematic review and meta-analysis","volume":"15","author":"Zhang","year":"2015","journal-title":"BMC Cardiovasc Disord"},{"key":"2023061412373351600_ytad259-B12","doi-asserted-by":"crossref","first-page":"2155","DOI":"10.1056\/NEJMoa1409312","article-title":"Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents","volume":"371","author":"Mauri","year":"2014","journal-title":"N Engl J Mede"},{"key":"2023061412373351600_ytad259-B13","first-page":"390","article-title":"Long-term dual antiplatelet therapy for secondary prevention of cardiovascular events in the subgroup of patients with previous myocardial infarction: a collaborative meta-analysis of randomized trials","volume":"37","author":"Udell","year":"2015","journal-title":"Eur Heart J"}],"container-title":["European Heart Journal - 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