Slides
Left Main Bifurcation Lesion Treated by Simple Cross-Over Stenting
- Operator : Seung-Jung Park
| Left Main Bifurcation Lesion Treated by Simple Cross-Over Stenting |
| - Operator: Seung-Jung Park, MD |
| Case Presentation |
| A 65 year-old man was referred to our hospital for the treatment of LM bifurcation lesion. His coronary risk factors were hypertension, hyperlipidemia, and ex-smoker. The physical examination was normal. The ECG and cardiac enzymes were unremarkable. The echocardiography showed normal left ventricular function (EF=64%) without regional wall motion abnormality. Thallium test showed reversible large sized perfusion defect at LAD territory. |
| Baseline coronary angiography |
| The right coronary angiogram was normal. The left coronary angiogram showed diffuse and tight stenosis at distal LM bifurcation lesion (  Movie 1, Movie 2). |
| Procedure |
| An 7 Fr sheath was inserted through right femoral artery, and the left coronary ostium was engaged with an 7 Fr XB 3.5 catheter with side hole. A 0.014 inch BMW wire was inserted into LAD and a 0.014 inch Soft wire was inserted into LCX (Figure 1). Firstly, we examined lesions with IVUS to make a decision ( Movie 3; LAD IVUS, Movie 4; LCX). LCX IVUS showed relatively preserved LCX ostium with aneurismal changes. Therefore, we intended to treat the lesions with simple cross-over technique. A 0.014 inch Soft wire was changed from LCX to Di to protect the Di. Without predilatation, a 3.5 x 38mm Xience Prime stent was implanted at LMos to mLAD (Figure 2). And then, postdilatation using a 4.5 x 15mm Quantum balloon was performed (Figure 3). The following coronary angiogram showed well-expanded stent, not-jailed LCX artery ( Movie 5). |
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