A self-expandable coronary stent system to treat complex coronary stenosis complicated by poststenotic aneurysm: an optical coherence tomographic evidence-based case report.

Coronary artery aneurysm is a relatively uncommon disorder characterized by coronary artery dilatation with diameter that exceeds 50% of the normal adjacent segments with atherosclerosis being the most common etiology. Aneurysms can be adjacent to a stenosis in a post- or prestenotic location. Both anatomical conditions are technically challenging regarding their percutaneous treatment because of the large discrepancy in size between the stenotic and dilated segments, and require careful choice of the most appropriate technique and device. We have successfully treated a coronary stenosis complicated by a poststenotic aneurysm in a 60-year-old patient with atypical angina using a novel self-expandable coronary stent system implanted with optical coherence tomography (OCT) guidance. OCT scan after implantation showed residual stent malapposition inside the aneurysm despite postdilatation. Thanks to the ability of this stent to self-expand over time, 6-month OCT follow-up showed an optimal result in terms of stent apposition, strut coverage, and absence of in-stent restenosis.