Case presentation

A 68 year-old male presented with chest pain upon effort for 2 years. He had a hypertension as a coronary risk factor. The echocardiography showed a normal LV ejection fraction of 58% without wall motion abnormality. Left coronary angiogram showed a diffuse stenosis at the first obtuse marginal (OM) branch with a diffuse LAD stenosis (Figure 1). Right coronary angiogram showed a mild narrowing at the distal RCA.

The diffuse LAD lesion was treated well with two (2.75 x 32 mm and 3.5 x 24 mm) Taxus stents (Figure 2). For the diffuse OM lesion, predilation was performed (Figure 3, Figure 4). Then, a 3.0 x 28 mm R stent was inserted into the OM lesion without difficulty and deployed successfully (Figure 5, Figure 6).

Operator¡¯s impression

Because the left circumflex coronary artery is often very tortuous and not aligned well with the guiding catheter, we used to have a difficulty in implanting a stent. From the case, we realized that the R stent has a very good trackability and pushability for complex coronary lesions.