Slides Coronary Left Main
LM Bifurcation Treated by Crush Technique
- Operator : Seung-Jung Park
LM Bifurcation Treated by Crush Technique |
- Operator: Seung-Jung Park, MD |
Case Presentation |
A 60 year-old male was admitted with effort chest pain for 4 months. His coronary risk factors were hypertension, diabetes, history of cerebrovascular infarct and ex-smoker. The physical examination was normal. His baseline ECG and cardiac markers were unremarkerable. |
Baseline Coronary Angiography |
Procedure |
An 8F sheath was inserted through right femoral artery, and the left coronary artery was engaged with an 8F JL catheter with 3.5 cm curve. 0.014-inch Runthrough NS wire was inserted into the LCX. 0.014-inch 190cm BMW guidewire was inserted into the LAD. Proximal LAD to LM was predilated with 2.0 x 20mm Tazuna balloon. And then, we pre-dilated pLCX using 2.0 X 20mm Tazuna balloon.(Figure 1) A Resolute integrity 3.5 X 12 mm Stent was successfully deployed at pLCX.(Figure 2) We performed crushing with a Empira NC 3.5(15) at dLM to pLAD.(Figure 3) And a Resolute integrity 4.0 X 22 mm Stent was successfully deployed at distal LM to proximal LAD.(Figure 4) And 0.014-inch Runthrough NS wire was inserted into the LCX. Additional kissing ballooning was performed by using a Empira NC 3.5(15) at dLM-pLAD and a SAPPHIRE NC 3.5 X 15mm at pLCX.(Figure 5) Thereafter, A Resolute integrity 3.5 X 18 mm Stent was successfully deployed at mLAD. Final left angiogram and IVUS showed that the procedure was successful.( Movie 4, Movie 5) |
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