Slides
Left Main to Proximal LAD and LCX Disease Treated by Simple Cross-Over Stenting
- Operator : Seung-Jung Park
Left Main to Proximal LAD and LCX Disease Treated by Simple Cross-Over Stenting |
- Operator: Seung-Jung Park, MD |
Case Presentation |
A 72 year-old man was admitted with effort chest pain for 2 months. His coronary risk factors were hypertension, diabetes, hyperlipidemia and ex-smoking. The physical examination was normal. The ECG and cardiac enzymes were unremarkable. The echocardiography showed normal left ventricular function (EF=66%) without regional wall motion abnormality. Cardiac stress perfusion CT showed significant stenosis with reversible perfusion defect of LAD territory. |
Baseline Coronary Angiogram |
Procedure |
An 8 Fr sheath was inserted through right femoral artery, and the left coronary ostium was engaged with an 8 Fr JL 4.0 catheter with side holes. Then 0.014-inch 190 cm BMW wire and 0.014-inch 180 cm Sion wire were inserted in LAD and LCX sequentially (Figure 1). We performed IVUS evaluation of LCX and middle LAD to LM lesion. The IVUS imaging revealed that LCX ostium was preserved (Figure 2). Therefore, we decided to perform one stent strategy with simple cross-over stenting. Direct stenting with Xience Xpedition stent 4.0 x 23mm was done at LM to proximal LAD with instent balloon dilatation up to 14 atm (Figure 3). Post stent IVUS evaluation was performed. IVUS imaging showed well positioned and expanded stent. And CAG showed that LCX ostium remained patent. So, we didn¡¯t perform additional kissing balloon. The Final angiogram showed that the procedure was successful ( Movie 5, Movie 6). |
Leave a comment
Sign in to leave a comment.
Comments