IVUS-Guided Tip Detection and Distal Anchor Assisted Stent Push for a Protruding Ostial Stent

Excessive aorto-ostial stent protrusion requires appropriate adjustment to achieve an optimal landing zone. We report a successful resolution using intravascular ultrasound (IVUS)-guided tip detection (TD) and the stent push technique under distal anchor balloon support.

A drug-eluting stent deployed at the right coronary artery ostium protruded excessively into the aorta, causing guiding catheter dislodgment. Using the IVUS-guided TD method, a guidewire was successfully advanced into the stent lumen. Under distal anchor balloon support, the stent push technique was performed to correct the protruding stent to an optimal position.

IVUS-guided TD enables real-time visualization of the proximal stent edge and wire tip, facilitating accurate rewiring. Distal anchor balloon support provides sufficient backup for effective longitudinal stent deformation.

The IVUS-guided TD method combined with a distal anchor balloon-supported stent push technique is an effective strategy for managing excessive aorto-ostial stent protrusion.