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Successful Management of a Complex Coronary Bifurcation Lesion in Acute Coronary Syndrome Using a Free‐Metal Approach

Year: 2026
Type: article
Study design: Case Report
Abstract: We present the case of a 56-year-old male with non-ST elevation myocardial infarction (NSTEMI) and a complex thrombotic lesion at the ostial left circumflex artery (LCX), extending into bifurcating marginal branches. Due to the high risk of side branch occlusion, a stentless strategy using thrombus aspiration, the reverse wire technique, and sequential plaque modification with a cutting balloon (Rodin-CUT technique) was employed. Following optimal lesion preparation, a drug-coated balloon (DCB) was deployed, achieving excellent angiographic and intravascular ultrasound (IVUS) results, with sustained vessel patency at 6-month follow-up. This case highlights the efficacy of a free-metal strategy in managing challenging bifurcation lesions while preserving side branches and avoiding the risks associated with permanent metallic implants.
Language: English
Subfield: Surgery
Field: Medicine
Open Access status: hybrid
Estimated APC paid: $4,490
OpenAlex ID: W7135077461
FWCI:
Cites: 5
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