“SKS is not dead” - A Case Report Of Dual Stenting Technique in the Management of a Complex Coronary Bifurcation Lesion During ST Elevation Myocardial Infarction

Abstract

Abstract Introduction Cardiac interventions in the setting of a ST-elevation myocardial infarction (STEMI) often require complex decision-making, especially when confronted with coronary bifurcation lesions. Although provisional stenting is the first choice regarding revascularization, bailout or upfront two stents may be required. Case presentation We present the case of a 53-year-old male patient with a history of arterial hypertension and type 2 diabetes who presented to our emergency department with an ST-elevation myocardial infarction associated with inferior and posterior wall involvement. The patient’s coronary angiogram revealed a thrombotic occlusion in the second segment of the right coronary artery. A dual stenting technique was employed using simultaneous kissing stents to address this complex coronary bifurcation lesion. Six months follow up with coronary angiography and optical coherence tomography demonstrated functional neo carina with no malapposition and successful endothelialization of two stents. Conclusions In our case, the simultaneous kissing stents approach was deemed appropriate due to the presence of a thrombotic bifurcation lesion involving both the posterior descending artery and retro posterior branch, while minimizing the risk of side branch compromise.