55-Year-old male, with a history of Hypertensive, known smoker presented with chest pain in Emergency room.Examining the patient we found out that his pulse was 80 per minute and Blood pressure was 120/80
Investigation revealed Hb – 12.5gm/dl, Serum Creatinine – 1.2mg/dl, Blood urea -42 mg/dl, RBS – 105 mg/dl. ECG showed evolved AWMI. 2D echo showed RWMA presented in LAD territory. Moderate LV function, EF – 45%.
Coronary Angiogram Revealed Left main coronary artery to LAD disease.
Procedure performed through right radial 7Fr EBU 3.5 guiding catheter. Check angiogram reveled LMCA to LAD disease. 0.014 Cougar XT wire placed in LAD and LCX. Pre-procedure OCT showed proximal to mid LAD thrombotic lesion. Proximal to mid LAD direct stenting done with 3.0x28mm Xience prime stent (DES). Then LMCA to LAD direct stenting done with 4.0x15mm Xience prime stent(DES). POT of LMCA done with5.0x8mm NC Balloon. Post OCT showed well apposed stent struts, no edge dissection and no malapposition. Final Angio showed good TIMI-III Flow without any dissection. Patient was discharged on 3rd
post-procedure day in a stable status.
OCT guided left main stenting is avalidated and safe method at specially in provisional stent strategy.
OCT enables better identification ofincomplete stent apposition and ideal for optimizing stenting in the LMCA.