Complex left main coronary stent restenosis treated through radial approach using a sheathless catheter.

A 64-year-old woman was admitted for non-ST elevation myocardial infarction. The coronary angiogram showed a severe stenosis in the left anterior descending artery (LAD) ostium. A 3.5 mm×18 mm everolimus-eluting stent was directly deployed in the left main and proximal LAD, with significant jailing of the circumflex (Cx) ostium. A 3.25 mm×11 mm everolimus-eluting stent was therefore deployed in the Cx using the T-stenting and small protrusion technique. One year later, the patient was readmitted for non-ST elevation myocardial infarction, and the coronary angiogram showed ostial restenosis of the Cx stent. Optical coherence tomography imaging confirmed the severity of ostial restenosis. Percutaneous coronary intervention by a radial approach was performed using a sheathless guide catheter.