The draw-back stent deployment technique: a strategy for the treatment of coronary branch ostial lesions

Isolated ostial lesions in the coronary tree are not uncommon; the percutaneous coronary intervention (PCI) of choice is stent implantation. This report describes a simple technique for accurate stent deployment to effectively treat such lesions without visible encroachment on the main vessel lumen. The stent is advanced distally into the sidebranch. Using a separate system, a balloon is inflated as a fulcrum in the main vessel within the segment straddling the sidebranch. The sidebranch stent is withdrawn undeployed until it contacts the inflated main vessel balloon and is then deployed. This technique was attempted in 14 cases and successful in 13, with excellent stent deployment and lesion resolution attained in 12 cases. There were no instances of main vessel aggravation or procedural events. Subsequent target vessel revascularization has been necessary in two patients. This technique is a simple approach for managing these troublesome lesions.