Trans-Radial Intervention for a Very Long Lesion of the Circumflex Artery

- Operator : Shigeru Saito

Trans-Radial Intervention for a Very Long Lesion of the Circumflex Artery

- Operator: Shigeru Saito, MD, Seung-Jea Tahk, MD, Myeong-Ho Yoon, MD
Case presentation
A 61 year-old female patient had complaint of effort chest pain for 8 months. Her coronary risk factors were smoking and hypercholesterolemia. The Baseline EKG was normal. Echocardiography revealed good LV function with an EF of 67%.
Baseline Coronary Angiography
1. Left coronary angiogram showed a very long lesion of the left circumflex artery (LCX) and a subtotal occlusion of the 1st obtuse marginal (OM) branch.(Figure 1)
2. Right coronary angiogram showed a total occlusion of the proximal segment.
Procedures
A 6.5F radial sheath was inserted through the right radial artery and the left coronary artery was engaged with a 6F EBU catheter. The LCX and OM branch were wired with two 0.014 inch Magic-FA wires. From the LCX lesion was predilated with a 1.5 x 20mm and a 2.5 x 20mm Ryujin balloon.(Figure 2, Figure 3, Figure 4) The proximal portion of the OM branch was also predilated with a 1.5 x 20 mm and a 2.0 x 20 mm Ryujin balloon.(Figure 5) After stenting with a 2.5 x 33mm Cypher stent in the OM branch,(Figure 6) a 2.75 x 32mm and a 3.0 x 28mm Taxus stents were deployed from the distal to proximal LCX sequentially with overlapping.(Figure 7, Figure 8) Final angiogram showed a good result.(Figure 9, Figure 10)

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