Slides
Left Main Shaft, proximal LAD and distal LAD disease Treated by Simple Cross-Over Stenting
- Operator : Seung-Jung Park
Left Main Shaft, proximal LAD and distal LAD disease Treated by Simple Cross-Over Stenting |
- Operator: Seung-Jung Park, MD |
Case Presentation |
A 60 year-old gentleman was admitted with effort chest pain for several months. His coronary risk factors were hypertension and hyperlipidemia. The physical examination was normal. The ECG and cardiac enzymes were unremarkable. The echocardiography showed normal left ventricular function (EF=57%) without regional wall motion abnormality. Treadmill test was positive and thallium test showed large reversible perfusion defect of LAD and RCA territory. |
Baseline Coronary Angiogram |
|
Procedure |
An 8 Fr sheath was inserted through right femoral artery, and the left coronary ostium was engaged with an 8 Fr XB 3.5 catheter with side hole. First, by using the FINECROSS 0.014-inch 1.8Fr microcatheter, 0.014-inch Shinobi guidewire was inserted in LAD. After that wire was exchanged by 0014-inch BMW 300cm guidewire. Predilatations were performed with 2.5 x 20mm TREK balloon at proximal LAD and middle LAD (Figure 1, Figure 2). We performed IVUS examination and IVUS showed significant stenosis from distal LM to middle LAD. Resolute intergrity stent 2.5 x 18mm, Resolute intergrity stent 3.5 x 22mm and Resolute intergrity stent 4.0 x 34mm were implanted at middle LAD to LM (Figure 3, Figure 4, Figure 5). The Final angiogram showed that the procedure was successful ( Movie 5, Movie 6). |
Leave a comment
Sign in to leave a comment.
Comments