Slides Coronary In-stent Restenosis
The Treatment of ISR at pLCX using Drug Eluting Balloon
- Operator : Seung-Jung Park
The Treatment of ISR at pLCX using Drug Eluting Balloon |
- Operator: Seung-Jung Park, MD |
Relevant clinical history and physical exam |
A 69 year-old gentleman visited our hospital because of recurrent episodes of angina. He already underwent PCI with Cypher 3.5 x 33 mm stent at LM-pLAD 2 years ago and with Xience V 3.0 x 23 mm stent at pLCX 1 year ago, respectively. Treadmill exercise test showed ST depression at stage 4. He had hypertension and diabetes. |
Relevant catheterization findings |
The left coronary angiogram showed tight ISR of pLCX stent and patent LM-pLAD stent ( Movie 1). The right coronary artery showed normal angiogram. |
Procedural step |
A JL3.5 SH 8Fr guiding catheter was engaged into the left coronary artery through the right femoral artery. A 0.014-inch BMW wire and another 0.014-inch BMW wire were inserted into the LAD and LCX, respectively. First above all, we dilated ISR lesion of pLCX using a 3.0 x 10 mm cutting balloon (Figure 1). Thereafter, kissing balloon inflation was performed using a Dura Star 3.5 x 15 mm at LM-pLAD and a Dura Star 3.0 x 15 mm at pLCX (Figure 2). Subsequently, we performed drug eluting balloon inflation (SeQuent Please 2.75 x 20 mm) at pLCX (Figure 3). Final angiogram showed no residual in-stent narrowing in pLCX stent ( Movie 2). |
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