Ultrasound findings in a coronary bifurcation lesion treated using the frontier dedicated stent system

A 66-year-old man with hypertension and acute coronary syndrome without ST segment elevation underwent cardiac catheterization. Single-vessel disease was observed at the bifurcation of the left anterior descending artery and diagonal artery (LAD-Dg), which was treated with an 18-mm MultiLink Frontier dedicated stent mounted on a dual balloon system that leaves a metal-free side portal oriented toward the secondary branch. The baseline study (Figure 1) showed a lesion in the LAD-Dg (Medina classification, 0,1,1). Ultrasound study of the main vessel showed the following: 1) proximal segment, eccentric plaque (from 5 to 9 o clock) and positive remodeling, preserving the lumen area; 2) carina with Dg branch (arrow at 2 o clock) and a septal branch (asterisk at 8 o clock); 3) plaque with severe calcification, image indicating negative remodeling, and lumen area <4 mm2; and 4) distal reference, normal trilaminar structure. The outcome following treatment with the 3×18-mm Frontier device is shown in Figure 2. In Figure 2A, the stent is observed in the main vessel, preserving the geometry of the bifurcation, and the metal-free portal is oriented toward the Dg: 1) proximal segment, adequate IMAGE IN CARDIOLOGY