Calcified bifurcation lesion - LIVE case

A 59-year-old female patient with type 2 DM, dyslipidaemia, hypothyroidism and impaired LV function (39%) presented with multivessel disease. RCA PCI was performed 3 days ago. 

The prox and mid LAD showed a severe calcified lesion including the diagonal. The lesion was prepared using a 1.25 Rotaglide™ ('single-person' technique), followed by a 2.5 mm IVL. 

The bifurcation was treated with an IVUS-guided stent (2.5 - 38 mm). This provisional stenting was completed by DEB kissing in the diagonal ostium and post-dilatation of the proximal LAD.

LIVE case from Apollo Hospital - Chennai, India

 
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Key moments: 

• 06:30-08:40 - Angiography analysis
• 18:07-19:52 - Procedural strategy
• 21:00-22:53 - IVUS guidance before Rotablator
• 24:36-29:00 - Rotablator with a 'single-person' technique
• 32:00-34:52 - IVUS guidance after Rotablator
• 49:20-53:58 - IVUS guidance post IVL
• 1:18:30-1:20:30 - Final IVUS

Keywords: Provisional stenting, calcified non-left main bifurcation, Rotablator, IVL, drug-eluting balloon