An 8F sheath was inserted through right femoral artery, and the left coronary ostium was engaged with an 7F JL catheter with 4 cm curve. Two 0.014 inch BMW wires were inserted into the LAD and RI. To evaluate the functional status of LM, FFR was done. FFR was normal (0.99 before adenosine and 0.93 after adenosine). After 0.014 inch BMW wire was inserted into the Di, predilatation was done using the Voyager Trek 2.5 X 15mm and Voyager NC 3.0 X 15mm. (Figure 1, Figure 2) After IVUS examination, Xience Prime 2.75 X 28mm and 3.0 X 23mm were deployed at the proximal to mid LAD. (Figure 3, Figure 4) After then, to evaluate the functional status of D1, FFR was done. FFR was normal (1.00 before adenosine and 0.86 after adenosine). However, there was a dissection of LM ostium on IVUS. So we deployed the Xience Prime 4.0 X 12mm stent at the LM ostium to distal LM even though the functional status of LM was normal. ( Movie 3) Final left angiogram showed that the procedure was successful. ( Movie 4, Movie 5) |
Leave a comment