Treatment of LM Ostial Stenosi

- Operator : Seung-Jung Park

Treatment of LM Ostial Stenosis
- Operator: Seung-Jung Park, MD
Case Presentation
A 60 year-old gentleman was admitted due to effort chest pain for 3 months. His coronary risk factor was ex-smoking. The echocardiography showed normal LV systolic function (EF=73%) without RWMA. Treadmill test was positive at stage 2 and thallium scan showed reversible large defect of LAD territory.
Baseline coronary angiography
The left coronary angiogram showed tandem lesions at LM ostium and mid LAD ( Movie 1, Movie 2, Movie 3). The right coronary was normal.
Procedure
An 8 Fr JL 4.0 guiding catheter was engaged into the left coronary ostium. A 0.014 BMW and Soft wire were inserted into the LAD and LCX, respectively (Figure 1). Predilatation for lesion modification was done using a TREK 2.5 x 20mm balloon at LM and pLAD. We deployed a PROMUS Element stent 3.5 x 38mm at the LM os to pLAD (Figure 2). Thereafter, post-stenting adjunctive balloon dilatation was done using Dura Star 4.0 x 20mm (Figure 3). Final angiogram showed well-expanded and well-positioned stent ( Movie 4, Movie 5).

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