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To the Editor: A 54‐year‐old man was admitted for progressive chest pain. Four years ago, the patient had surgical aortic valve replacement (SAVR), and preoperative multislice computed tomography (MSCT) showed no coronary stenosis. A year after SAVR, he presented with chest pain, and coronary angiogram revealed an isolated ostial left main coronary artery (LMCA) stenosis [Figure 1a]. A 4.0 mm × 18.0 mm stent (Medtronic Vascular, Santa Rosa, CA, USA) was implanted without a high‐pressure postdilation [Figure 1b]. The patient was discharged on aspirin, ticagrelor (replaced with clopidogrel after 3 months), and statins. Unfortunately, the stent was found to protrude into the aorta by approximately 10 mm by MSCT at 4‐month follow‐up [Figure 1c].

Stenting for Aorto-Ostial In-Stent Restenosis via Side Strut of an Excessively Protruding Stent Guided by Intracoronary Imaging