1st Operator: Yangsoo Jang / 2nd Operator: Hoyoun Won

A 70-year-old man underwent PCI for LAD (CTO) and LCx lesions in 2012. Recent echocardiography and MIBI scan showed ischemic findings at LAD and RCA territory, and follow angiography also demonstrated RCA-CTO.

• Previous MI: N

• Previous CABG : N

• Previous PCI: Y

• Diabetes: N
• Hypertension: N
• Hyperlipidemia: Y

• Smoking: Y (former, 30 pys)
• Family History: N

• Age: 70
• Sex: Male

Stable angina

Echocardiography

Moderate hypokinesia of inferoseptal segment at base-mid LV, LVEF 58%

Treadmill test

Not done

Thallium SPECT

Mild reversible defect in the apico to mid anterior wall / Moderate perfusion decrease in the inferior wall.

CTO at pRCA (TIMI 0)
Patent previous stents at LAD and LCx
Diffuse eccentric upto 80% LN of dLCx, and collateral flow from dLCx to PL
Collateral flow from dLAD to LCx

Target Lesion(s)

pRCA

• ASA: Y
• LMWH: N

• Clopidogrel: Y
• Heparin: N

• Nitrates: Y
• IIb/IIIa: N

• Other: carvedilol SR 16 mg, rosuvastatin 20 mg