• 50/M non HTN,non DM underwent PTCA+ stent to LAD (3.5 x 18 SES) in June 2013
• LAD ISR in nov2013
• PTCA + DES toLAD (4 x23 pronova XR) in nov 2013
• Now presentedwith effort angina 3 months Ostial Lcx Lesion.mpg Ostial Lcx Lesion.mpg
His ECG was normal.His CBC was normalS. Creat-- 0.9RBS> 130 mg%LFT -Normal2DECHO was normal
CAG was done through Rt RadialLM to LAD stent was patentLCX--> Dominant, ostial 90% stenosisRCA-> Non Dominant normal Ostial Lcx Lesion.mpg
Access: Right femoral artery
Guide; 7F EBU
Wires: 2 Rinato wires were usedLM was engaged with 7F EBU.
LAD was crossed with Rinato0.014"
LCx was engaged with 0.014 Rinato
LCx lesion initailly predialted with 1.5 x8semicompliant sprinter balloon
Then predialted with 2 x 8 semi-compliant up to 10 atmThen 3 x16 Resolute Onyx was implanted at Ostail LCx at 16 atmNo dissection, no slow flowFKI was done with 3x8 NC balloon in LAD and 3.5 x 8 NC balloon in LCx at 12 atmNo Slow flowFinal result was excellent Stent implantation.mpg FKI.mpg final2.mpg
LM Interventions are very risky.Correct Technique are useful.This patient developed Ostial LCx Lesion which was successfully treated with PCI. DK crush could have been used but I preferred TAP.Result was excellent.Patient is asymptomatic in routine follow-up.