Slides
Treatment of Distal LMCA Bifurcation Stenosis Using Modified T-Stenting Technique without Final Kissing Balloon Angioplasty
- Operator : Augusto D. Pichard
Treatment of Distal LMCA Bifurcation Stenosis Using Modified T-Stenting Technique without Final Kissing Balloon Angioplasty |
- Operator: August D. Pichard, MD |
Case Presentation |
The patient was a 69 year old man with effort chest pain and dyspnea on exertion. His coronary risk factors were hypertension and hyperlipidemia. The echocardiography showed normal left ventricular function (EF=57%) without regional wall motion abnormalities. Treadmill test was positive at stage 1 and thalium SPECT showed reversible large defect in LAD and LCX territory. |
Baseline coronary angiography |
The left coronary angiogram showed tight stenosis at distal LMCA bifurcation ( Movie 1, Movie 2). The right coronary angiogram showed minimal disease. |
Procedure |
An 8F sheath was inserted through right femoral artery and the left coronary ostium was engaged with an 8F EBU 3.5 guiding catheter. A 0.014 inch BMW wires and a soft wire were inserted into the LAD and LCX, respectively. Distal LM to proximal LCX and proximal LAD lesions were predilated with 3.5 x 10mm cutting balloon (Figure 1, Figure 2). After predilation, 3.5 x 12mm Xience V stent was implanted at LAD os to proximal LAD first (Figure 3) and then 3.5 x 28mm Xience V stent was implanted at LM to proximal LCX using ¡®modified T-stenting technique¡¯. Final kissing balloon angioplasty was not done because angiogram showed a excellent result with well-expanded stents ( Movie 3, Movie 4). |
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