Figure 6.

First example of restenosis in SKS and its treatment with SKS (Case 17 in Table 3). An obese diabetic female patient aged 70 years had undergone implantation of a Sorin 21 mm prosthetic aortic valve replacement in 2003. She developed angina in 2015, was found to have a bifurcation LMS lesion, and this was successfully stented using SKS (3.5 × 20 mm and 3.0 × 16 mm Promus Premier™ stents). She represented with crescendo angina 1 year later while taking triple antithrombotic therapy. Repeat coronary angiography demonstrated restenosis at the bifurcation, affecting both limbs of the SKS (A), whilst the original stents appeared well deployed. Two wires were passed and predilatation was performed with simultaneous kissing 3.0 mm balloons at high pressure (B). Repeat SKS was undertaken using 3.5 × 20 and 3.5 × 16 mm Promus Premier™ DES at 16 atm (C). The final result was excellent (D). Recovery was uneventful and she was asymptomatic 1 year later. This case is also demonstrated as a video in the Online Supporting Information