Stent Delivery to Using Guidezilla

- Operator : Jung-Min Ahn

Stent Delivery to Using Guidezilla
- Operator: Jung-Min Ahn, MD
Case Presentation
A 51 years old male patient was hospitalized for resting chest pain started 2 hours ago. He received LM to diagonal branch stenting 3 years ago because of total occlusion of mid LAD. Cardiac enzyme has elevated without ST change on the ECG.
Baseline Coronary Angiogram
  1. Left and coronary angiogram showed patent stent at LM to Diagonal branch, mid LAD total occlusion and distal LCX total occlusion with thrombi. ( Movie 1)
  2. The right coronary angiogram showed diffuse stenosis at proximal to mid RCA. ( Movie 2)
Procedure
A 7 Fr sheath was inserted thorough the right femoral artery and left coronary artery was engaged with a 7 Fr JL 4 guiding catheter. The wire, 0.014-inch Runthrough was inserted into the LCX. Thrombectomy was performed to aspirate thrombi located proximal site of distal LCX total occlusion. Pre-dilation performed with a Tazuna 2.5 x 15 mm balloon (Figure 1). And then Synergy 3.0 x 38mm was deployed at distal LCX lesion. ( Movie 3) After stenting, slow flow was observed and there was another lesion at distal site of stented lesion. We tried to deliver NC emerge 2.0(15) balloon, however it was difficult because the angle and stent struts. Then we inserted Guidezilla up to distal site of LCX stent and delivered balloon easily. (Figure 2) And Synergy 2.5(20) was deployed in far distal LCX lesion Final angiogram and IVUS showed that the procedure was successful. ( Movie 4).

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