LM Stenting

- Operator : Seung-Jung Park

LM Stenting
- Operator: Seung-Jung Park, MD
Case Presentation
A 62-year-old male patient was admitted for chest discomfort started 1months ago. The coronary angiography showed severe stenosis at left main (LM) bifurcation site. His coronary risk factor was hypertension only. The physical exam and electrocardiogram (ECG) were normal. Echocardiography showed normal ejection fraction without regional wall motion abnormalites.
Baseline Coronary Angiogram
  1. Left and coronary angiogram & IVUS showed severe stenosis at LM to the proximal left anterior descending (LAD) and proximal LCX ( Movie 1).
  2. The right coronary angiogram showed normal coronary angiogram ( Movie 2).
Procedure
An 8Fr sheath was inserted thorough right femoral artery and, left coronary artery was engaged with an 8 Fr JL 4 guiding catheter. 0.014-inch BMW 190 cm wire was inserted into LAD and another BMW wire was inserted into LCX. Pre-dilation performed with a Emerge 2.5 x 15 mm balloon and a Raiden 3 3.5 x 15 mm balloon. The Xience Sierra stent 4.0 x 15 mm was successfully deployed at LCX by crush technique with Sapphire NC 4.0 x 15 mm balloon ( Movie 3). Then Xience Sierra 4.0 x 18 mm was implanted at LM to the proximal LAD ( Movie 4, Movie 5). The kissing balloon was performed with Sapphire NC 4.0 x 15 mm balloon in LAD and Raiden 3 3.5 x 15 mm balloon in LCX ( Movie 6). Final angiogram and IVUS showed that the procedure was successful ( Movie 7).

Appendix
IVUS image of pre-procedure ( Movie 8) and final image ( Movie 9)

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