> Cases

1st Operator: Paul Hsien-Li Kao / 2nd Operator: Gyung-Min Park

Brief Case Summary

A 70 year-old male was admitted for effort chest pain started from 6 months ago. He underwent balloon angioplasty at distal LAD stenosis 19 years ago. Following coronary angiogram showed total occlusion at proximal RCA, diagonal branch and severe stenosis at distal LCX, distal LAD.

Past Medical History

  • Previous MI: N
  • Previous CABG : N
  • Previous PCI: Y
  • dLAD POBA (2000-05-12)

Demographic Characteristics

  • Diabetes: Y
  • Hypertension: N
  • Hyperlipidemia: N
  • Smoking: N
  • Family History: N
  • Age: 74
  • Sex: Female

Clinical Presentation

Stable angina

Non-invasive Studies

Echocardiography

None

Treadmill test

None

Thallium SPECT

None

Cardiac Catheterization Findings

  • The left coronary angiogram showed total occlusion at diagonal branch, stenosis at distal LCX, LAD and collateral flow from OM to PL.
  • The right coronary angiogram showed total occlusion at proximal RCA.

Case Notes

Target Lesion(s)

CTO lesion at proximal RCA

Planned device(s)

Intravascular ultrasound

Adjunctive Medication

  • ASA: Y
  • LMWH: N
  • Clopidogrel: Y
  • Heparin: N
  • Nitrates: N
  • IIb/IIIa: N
  • Other(s): Statin, CCB, BB
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