Slides

Distal LMCA stenosis Treated by Simple Cross-Over Stenting

- Operator : Duk-Woo Park

Distal LMCA stenosis Treated by Simple Cross-Over Stenting
- Operator: Duk-Woo Park, MD
Case Presentation
A 64 year-old gentleman was admitted with effort chest pain for two months. His coronary risk factor was diabetes mellitus. The treadmill test showed stage 2 positive. The ECG and cardiac enzymes were unremarkable. The echocardiography showed normal left ventricular function (EF=61%) without regional wall motion abnormality. Thallium SPECT was not done.
Baseline coronary angiogram
1. A left coronary angiogram showed significant tight narrowing of distal left main coronary artery ( Movie 1, Movie 2, Movie 3, Movie 4).
2. A right coronary angiogram was normal.
Procedure
An 8 Fr sheath was inserted through right femoral artery, and the left coronary artery ostium was engaged with an 8 Fr JL 4.0 catheter with side hole. First, we inserted a choice PT 0.014-inch guidewire into LAD. An BMW 0.014-inch guidewire was inserted to protect the LCX. Predilatation was performed with a 3.0 x 15mm Amadeus balloon at distal LM. After predilatation, Promus Element stent 4.0 x 20mm was implanted at LM to pLAD. Thereafter, post-stenting adjunctive balloon dilatation was done by using a 4.5 x 15mm Quantum balloon (Figure 1, Figure 2, Figure 3, Figure 4). The following coronary angiogram showed well-expanded LM stent, not-jailed LCX artery and OM branches ( Movie 5, Movie 6).

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