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Figure 1. Clinical case with SYNERGYTM and schema of PPSP procedure. A. Baseline coronary angiogram; B. Longitudinal 3D-OCT cut-away view of inadequate jailing and proximal rewiring; C. Final coronary angiogram; D. Final 3D-OCT image; E. Schema of PPSP procedure with X-ray fluorogram and 3D-OCT image of case with two-link BMX-JTM stent (Biosensors International Group Ltd.); * and , same links divide distal cell at rewiring; arrowhead, re-crossed wire. If distal rewiring is selected for inadequate jailing (distal cell on a side-branch ostium divided by a stent-link) during single two-link stent deployment at the coronary bifurcation with side-branch dilation, kissing balloon inflation (KBI) might result in residual deformed struts in the side-branch ostium, and a sparse strut-covered distal main vessel. Although adequate rewiring during inadequate jailing might be proximal rewiring [Nakao F. The impact of proximal cell rewiring compared with distal cell rewiring with single-stent deployment and subsequent kissing balloon inflation in the inadequate jailing of a Kanam stent on the side branch ostium. Cardiol J. 2017 Jun 27; ahead of print], simple KBI might result in residual metal carina. The sequence of procedures should also be considered. A SYNERGYTM two-link stent (Boston Scientific Co.) was deployed in the main vessel of a bifurca-

Proximal optimization technique, proximal rewiring, side-branch dilation and paired balloon inflation to minimize metal carina in inadequate jailing