Carina shift as a mechanism for side-branch compromise following main vessel intervention: Insights from three-dimensional optical coherence tomography

Three-dimensional rendering of optical coherence tomography (OCT) images is a method that can be used for providing additive information for assessing the result of percutaneous coronary intervention (PCI), especially in complex lesions such as in bifurcations (1). While plaque shift has been considered the main underlying mechanism for side-branch compromise after stenting (2), new theories challenge the role of plaque shift and suggest carina shift to be a major contributor (3-6). We present a case were on-line three-dimensional OCT was used to demonstrate the role of carina shift in side-branch pinching, following main vessel intervention.