Intravascular ultrasound-guided tip-detection antegrade dissection and re-entry as a bailout strategy for calcification-induced side-branch occlusion during complex percutaneous coronary intervention: a case report.

ABSTRACT:

Background

Percutaneous coronary intervention (PCI) for heavily calcified bifurcation lesions presents unique challenges, side-branch occlusion representing a serious complication. Tip-detection antegrade dissection and re-entry (TD-ADR), originally developed for chronic total occlusion, enables true lumen re-entry when guidewires advance subintimally. We report its novel application as an effective bailout technique for calcification-induced side-branch occlusion.

Case summary

A 67-year-old man with prior inferior myocardial infarction underwent PCI of a heavily calcified mid-left anterior descending (LAD) artery stenosis with ostial narrowing of diagonal branches D1 and D2. Rotational atherectomy and modified balloon dilation fragmented the calcific plaque, abruptly displa

SUBMITTER: Kawai K 

PROVIDER: S-EPMC12854407 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature