%O This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. %C United States %X A 58-year-old patient with hypertension, dyslipidemia, and typical angina symptoms was referred for a coronary angiogram following a computed tomography coronary angiogram showing a significant stenosis in the left circumflex artery (Figure 1A). This demonstrated moderate stenosis with a minimum lumen diameter (MLD) of 1.2 mm, diameter stenosis of 51%, and a quantitative flow ratio (QFR, Medis Imaging, Leiden, the Netherlands) assessment of 0.80 indicating a flow-limiting stenosis (Figure 1B). The patient was enrolled in the randomized TRANSFORM-I trial (Treatment of Small Coronary Vessels: MagicTouch Sirolimus Coated Balloon, NCT03913832),1 comparing the novel Magic Touch sirolimus-coated balloon (Concept Medical, Surat, India) to the SeQuent Please Neo paclitaxel-coated balloon (B.Braun, Berlin, Germany) in small vessels. The patient received treatment with a 2.5×30 mm SeQuent paclitaxel-coated balloon. The balloon was inflated for 60 s, resulting in an acute gain of 0.60 mm (MLD preprocedure versus MLD postprocedure: 1.20 versus 1.80 mm) and an improved postprocedure QFR of 0.91 (Figure 1C and 1D). The patient underwent optical coherence tomography (OCT) imaging postprocedure, which showed a minimum lumen area of 2.36 mm2 and an area stenosis of 46%, respectively. In addition, OCT revealed a nonflow-limiting dissection 12.6 mm in length (Figure 1E and 1F) that extended to the media with a maximum dissection arc of 153°, and a large dissection volume of 13.8 mm3 (Video S1). %J Circulation: Cardiovascular Imaging %K Blood viscosity; coronary angiography; hemodynamic; image processing, computer-assisted; tomography, optical coherence %L discovery10197953 %I American Heart Association %D 2024 %N 4 %T Two Facets of Shear Stress Post Drug Coating Balloon: Angiography Versus Optical Coherence Tomography Fusion Approach %A Eric KW Poon %A Kai Ninomiya %A Shigetaka Kageyama %A Xiaojing Guo %A Bernhard Reimers %A Ryo Torii %A Jouke Dijkstra %A Christos V Bourantas %A Johan HC Reiber %A Peter Barlis %A Yoshinobu Onuma %A Patrick W Serruys %V 17