Slides
Left Main Ostial Stenosis Treated with a Single Sirolimus-Eluting Stent Implantation
- Operator : Seung-Jung Park
Left Main Ostial Stenosis Treated
with a Single Sirolimus-Eluting Stent Implantation |
- Operator: Seung-Jung Park, MD, Ki Bae Seung, MD, |
Clinical Presentation |
A 76-year old man was admitted due to resting chest pain for 15 days. His coronary risk factor was diabetes mellitus. His baseline ECG and LV function were normal. |
Baseline Coronary Angiogram |
1. Left coronary angiogram showed a significant
left main coronary artery (LMCA) ostial narrowing (Figure
1, Figure
2). |
Procedure |
An 8F sheath was inserted through right femoral artery, and the left coronary ostium was engaged with an 8F JL catheter with 3.5 cm curve. Two 0.014 inch BMW wires were inserted into the left anterior descending artery (LAD) and left circumflex artery (LCX), respectively (Figure 3, Figure 4). IVUS examination showed non-significant plaque burden at the ostial LCX (Figure 5) and modest plaque burden at the distal LMCA (Figure 6). Therefore, a 3.5 X 18 mm Cypher stent was positioned at the LMCA extending to the ostial LAD and deployed at 16 atm (3.72 mm), crossing the LCX (Figure 7). And then, additional balloon inflation was performed with a 4.0 X 12 mm Sprinter at 15 atm (4.42 mm) for stent optimization (Figure 8). Final angiogram showed well-expanded stents without residual narrowing (Figure 9, Figure 10). |
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