Enhanced stent visualization systems during PCI: A case series and review of literature Simone Biscaglia, MD, Carlo Tumscitz, MD, Matteo Tebaldi, MD,

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Enhanced stent visualization systems during PCI: A case series and review of literature Simone Biscaglia, MD, Carlo Tumscitz, MD, Matteo Tebaldi, MD, Elisa Andrenacci, MD, Rita Pavasini, MD, Gianluca Campo, MD, Roberto Ferrari, MD, PhD Journal of Cardiology Cases Volume 12, Issue 1, Pages 1-5 (July 2015) DOI: 10.1016/j.jccase.2015.02.008 Copyright © 2015 Japanese College of Cardiology Terms and Conditions

Fig. 1 Combined imaging of stent fracture in the left main (LM) coronary artery. (A) Angiographic image of LM after stent placement. (B) ClearStent image of the stent fracture involving the mid portion of LM. (C) Stent fracture (intravascular ultrasound image). (D and E) Stent fracture (optical coherence tomography image). (F) Final result (ClearStent image). Arrows and * indicate stent fracture. Journal of Cardiology Cases 2015 12, 1-5DOI: (10.1016/j.jccase.2015.02.008) Copyright © 2015 Japanese College of Cardiology Terms and Conditions

Fig. 2 Thrombosis in gap between stents and multiple stent fractures. (A) Gap between stents and stent fractures (ClearStent image). (B–E) Optical coherence tomography images. (B) Stent fracture. (C) Stent thrombosis. (D) Gap between stents. (E) Distal part of the stent without thrombosis. Journal of Cardiology Cases 2015 12, 1-5DOI: (10.1016/j.jccase.2015.02.008) Copyright © 2015 Japanese College of Cardiology Terms and Conditions

Fig. 3 ClearStent-guided stent implantation in gap between two previously implanted stents. Journal of Cardiology Cases 2015 12, 1-5DOI: (10.1016/j.jccase.2015.02.008) Copyright © 2015 Japanese College of Cardiology Terms and Conditions

Fig. 4 Multi-imaging evaluation of stent under-expansion. (A and B) Angiographic images. (A) Stent thrombosis of distal left main coronary artery. (B) Stent under-expansion in proximal left circumflex artery (LCX). (C–E) Severe calcifications and stent under-expansion in proximal LCX by ClearStent (C), intravascular ultrasound (D), and optical coherence tomography (OCT) (E). (F and G) Final result by angiography (F) and OCT (G). Journal of Cardiology Cases 2015 12, 1-5DOI: (10.1016/j.jccase.2015.02.008) Copyright © 2015 Japanese College of Cardiology Terms and Conditions

Fig. 5 Lost stent crushed below another stent. (A) ClearStent image showing the lost stent crushed in proximal left anterior descending artery. (B and C) Intravascular ultrasound images. The arrows indicate the lost stent. Journal of Cardiology Cases 2015 12, 1-5DOI: (10.1016/j.jccase.2015.02.008) Copyright © 2015 Japanese College of Cardiology Terms and Conditions