Bail-out rotational atherectomy to ablate stent struts after treatment of a LAD bifurcation lesion with the trousers technique

We present a previously unreported complication of the "trousers" stent pro cedure used for treatment of a bifurcation lesion in the left anterior desc ending artery and the first diagonal branch. Closure of the main vessel occ urred. A balloon, however, could not be advanced across the side-branch ste nt to open the struts toward the main branch. Therefore, a bailout rotation al atherectomy was performed to ablate the stent that then allowed a furthe r dilatation with a PTCA balloon. This procedure resolved a potentially let hal outcome for the patient who subsequently underwent uneventful coronary by-pass grafting. (C) 2000 Wiley-Liss, Inc.