CASE REPORT article
Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1558491
This article is part of the Research TopicCase Reports in Coronary Artery Disease: 2024View all 17 articles
Trissing balloon inflation and Percutaneous Coronary Intervention with drug-coated balloons for the treatment of restenosis of a left main trifurcation lesion
Provisionally accepted
- 1Humanitas University, Rozzano, Italy
- 2Humanitas Research Hospital, Rozzano, Lombardy, Italy
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We report the case of a 62-year-old male with multiple cardiovascular risk factors and comorbidities who presented to our Institution due to unstable angina. One year earlier, he has undergone percutaneous coronary intervention (PCI) to unprotected left main trifurcation lesion involving ostial left anterior descending artery (LAD) (Medina classification 0-0-1-0) with provisional stenting technique with single drug-eluting stent (DES) implantation from left main to LAD, and PCI to LAD with single DES implantation from LAD in crossover with D1 for the treatment of LAD-D1 bifurcation lesion (Medina 1-1-0). A coronary angiography by radial approach found sub-occlusive restenosis of both jailed ostial ramus intermediate and LCX, with patency of DES to left main-LAD and a significant in-stent restenosis (ISR) of DES to LAD at the bifurcation with D1. LAD ISR was treated with PCI with single DES implantation with optimal angiographic result. The left main trifurcation restenosis was treated by radial approach PCI with simultaneous trissing balloon inflation to Left main, ramus intermediate and LCX, followed by kissing balloon with drug-coated ballons with sirolimus elution to ramus intermediate and LCX, subsequent trissing balloon inflation and final proximal optimization technique to the left main achieving an optimal angiographic result. A planned follow-up angiography at 1-year showed persistence of optimal angiographic result.
Keywords: Left main trifurcation, left main restenosis, left main angioplasty, In-stent Restenosis, complex PCI
Received: 10 Jan 2025; Accepted: 14 Apr 2025.
Copyright: © 2025 Amata, Gioia, Liccardo, Barberis and Ferrante. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Giuseppe Ferrante, Humanitas University, Rozzano, Italy
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