ArticleCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions2026
Excessive Ostial Stent Protrusion: Evaluation of Management Strategies and Clinical Outcomes of the Side Flap Technique.
Article in Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Case Report: The "metal ring" phenomenon: a rare cause of recurrent in-stent restenosis.Frontiers in cardiovascular medicine · 2026Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundsAccurate stent positioning in aorto-ostial lesions remains challenging due to complex three-dimensional anatomy, lack of optimal fluoroscopic projections, and high rates of geographic miss. Stent overhang impairs guide catheter re-engagement and complicates future revascularization. Despite its frequency, no standardized approach exists for managing excessive stent protrusions.
aimsThis study systematically evaluated management strategies for excessive aorto-ostial stent protrusion, integrating comprehensive bench testing with clinical case experience, and assessed the feasibility, mechanics, and outcomes of the Side Flap technique.
methodsBench experiments assessed multiple corrective strategies in two scenarios, guidewire crossing through the central stent lumen and through a side cell, across contemporary DES platforms. Mechanical feasibility, force transmission, stent deformation and expansion, and structural integrity were evaluated using high-pressure ballooning, catheter-assisted maneuvers, and intracoronary imaging. A retrospective multicenter series provided complementary real-world clinical outcomes of the Side Flap technique.
resultsLongitudinal stent compression using guide catheters, large balloons, or telescoping maneuvers proved mechanically ineffective and frequently produced severe stent deformation or malapposition. In contrast, intentional side-cell recrossing with creation of a neo-lumen was consistently feasible, structurally stable, and reproducible. All DES platforms tolerated large-diameter side-cell expansion without strut fracture, yielding circular neo-lumens with excellent apposition on OCT. Clinically, the Side Flap technique achieved high procedural success with no technique-related adverse events during follow-up.
conclusionsThe Side Flap technique offers a controlled and reproducible alternative strategy when true-lumen access is not achievable or fails, and represents a valuable addition to the interventional armamentarium. Longitudinal stent crush techniques are unreliable for managing excessive aorto-ostial protrusion.
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Registered trials
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