Slides
LM Bifurcation Treated by Mini Crush Technique
- Operator : Seung-Jung Park
LM Bifurcation Treated by Mini Crush Technique |
- Operator: Seung-Jung Park, MD |
Case Presentation |
A 59 year-old male was admitted with effort chest pain for 6 months. He underwent stent implantation at middle LAD and proximal to distal LCX, 7 months ago. His coronary risk factors were hypertension, diabetes and ex-smoker. The physical examination was normal. His baseline ECG and cardiac markers were unremarkable. |
Baseline Coronary Angiography |
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Procedure |
An 8F sheath was inserted through right femoral artery, and the left coronary artery was engaged with an 8F JL catheter with 4.0 cm curve. 0.014-inch BMW guide-wire was inserted into the LAD and another 0.014-inch 190cm BMW guide-wire was inserted into the LCX. On the LAD pull-back IUVS, MLA of LAD ostium was measured 3.2mm2 with plaque burden 87%. Proximal LCX was pre-dilated with 2.5 x 20mm Maverick balloon. And then, we pre-dilated LM to proximal LAD using 2.5 X 20mm Maverick balloon. (Figure 1, Figure 2) A Promus Premier 3.0 X 16 mm Stent was successfully deployed at proximal LCX to overlap previous stent. (Figure 3) Consecutive Promus Premier 4.0 x 28mm Stents was successfully deployed at LM to proximal LAD by Mini Crush technique. (Figure 4) 0.014-inch Choice PT guide-wire was exchanged into the LCX. Additional kissing ballooning was performed by using Empira NC 3.5 x 15mm Balloon at LM to proximal LAD and Empira NC 3.0 x 15mm Balloon at proximal LCX. (Figure 5) Final left angiogram and IVUS showed successful. ( Movie 4, Movie 5) |
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