Based on the OCT findings, a decision was made by the operator to implant an additional 5.0 x 12mm DES into the proximal LAD. Post-stent angiography showed satisfactory results, which were further verified by post-stent OCT pullback (Figure 4). OCT imaging confirmed successful thrombus removal with minor residual thrombus protrusion (Figure 4 C, arrow) and resolution of stent malapposition (Figure 4C-E). There was no stent edge dissection detected at the distal or proximal edge of the stent, minimal stent area was 12.5mm2
and percent stent expansion 87%.
In this case of NSTEMI with very late ST, OCT helped identify incomplete stent apposition as the cause of the event, select the most appropriate treatment strategy, and check whether optimal post-PCI targets were achieved at the end of the procedure.