Slides Coronary Ostial

Proximal LAD Bifurcation Lesion Treated with Simple Cross-Over Technique Using Single Drug-Eluting Stent

- Operator : Barry D. Rutherford

Proximal LAD Bifurcation Lesion Treated with Simple Cross-Over Technique Using Single Drug-Eluting Stent
- Operator: Barry D, Rutherford, MD
Clinical presentation
A 60-year old woman was admitted due to recurrent effort chest pain for 5 years. Her coronary risk factor was hypertension. Her baseline ECG was normal. Echocardiography showed normal LV systolic function (EF = 65%).
Baseline coronary angiogram
1. Left coronary angiogram showed significant narrowing of proximal LAD bifurcation (Figure 1, Figure 2, Figure 3)
2. Right coronary angiogram was normal
Procedure
An 8F sheath was inserted through right femoral artery, and the left coronary ostium was engaged with an 8F JL catheter with 3.5 cm curve. Two 0.014 inch Asahi Neo’s soft wires were inserted into the LAD and LCX, respectively. A 3.5 X 23 mm Cypher stent was placed at proximal to mid LAD and deployed at 20 atm (3.83 mm) (Figure 4, Figure 5). Post-stent IVUS revealed satisfactory result without malapposition of the stent. Final angiogram showed a well-expanded stents without residual narrowing (Figure 6, Figure 7).
||

Comments

  • Dobrin Vassilev 2007-05-05 Good case. It will be interesting what is the situation with the side branch ostium - it is not visible from above projections, some hazziness is seen at that place.
  • Vijay Kumar Puri 2007-11-18 what is the purpose of putting wire in lcx when it is lad diagonal bifircation vijay puri
  • Xuchen Zhou 2007-12-24 It is better to use IVUS to find if there is some stenosis at the ostium of D1. From the results of CAG, it is not the true bifurcation lesion. It is good to choose 1 stent to treat this lesion.

Leave a comment

Sign in to leave a comment.