Slides Coronary Long Lesion
Diffusely Calcified Long Lesion Treated Using Rotablation
- Operator : Jung-Min Ahn
Diffusely Calcified Long Lesion Treated Using Rotablation |
- Operator: Jung-Min Ahn, MD |
Case Presentation |
A 70 years old female patient had surgery of rectal cancer, 6 months ago. At that time, Thallium SPECT as a pre-operation evaluation exam showed reversible perfusion defect at RCA territory. After the surgery, she had exertion of dyspnea. For correction of anginal symptom, coronary angiogram was done. |
Baseline Coronary Angiogram |
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Procedure |
A 8 Fr sheath was inserted thorough the right femoral artery and right coronary artery was engaged with a 7 Fr JR 4 guiding catheter. The wire, 0.014-inch Sion was inserted into the RCA with help of Caravel micro-catheter. Pre-dilatation performed with a SAPPHIRE NC 2.5 x 18 mm balloon ( Movie 3). but it was failed due to calcified lesion. We decided to perform rotablation for calcified lesion and then inserted temporary pacemaker. A 0.014 inch Rotawire was placed into the RCA. Based on angiography image, we performed with a rotablator 1.25mm burr ( Movie 4). We changed a 0.014 inch Rotawire into a 0.014 inch BMW wire at RCA. Pre-dilatation at proximal to distal RCA with IKAZUKI 2.0 x 15 mm and SAPPHIRE NC 2.5 x 20 mm was performed ( Movie 5). After pre-dilatation, we deployed the Xience Alpine stent 2.5 x 38 mm at mdRCA ( Movie 6) and Xience Alpine stent 3.5 x 38 mm at pmRCA with help of Guide zilla 6Fr guide extension catheter ( Movie 7). Post-stenting adjunctive balloon dilatation with SAPPHIRE NC 3.5 x 15 mm was done. Final angiogram showed that the procedure was successful ( Movie 8). Appendix LAD IVUS image of post-rotablation ( Movie 9), post-stent ( Movie 10), and final image ( Movie 11) |
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