04 Mar 2023
Calcified left main bifurcation PCI: how to evaluate and how best to treat - LIVE case
Provisional stenting on calcified distal left main stenosis
Summary
A 62-year-old male with hormonal treatment (metastatic prostate carcinoma) presents an exertion angina due to an MVD: severe calcified stenoses of distal left main (medina 1-1-1), mid LAD and prox CX.
Watch how the operators prepare LAD and CX lesions with Rotablator (Burrs: 1.25 + 1.75) then NC balloons and 1 stent per lesion. For LM, they plan to do a 2 stents technic. However, after shockwave (4.0 mm) they perform a provisional stenting (LM to LAD) with POT and Kissing. IVUS was performed only at the beginning of the procedure from CX to LM.
LIVE case from Sunninghill hospital, Johannesburg - South Africa
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Key moments
- 17:14-55:28 - Rotablator of LAD and CX
- 01:08:17-01:12:00 - Shockwave technique
Keywords: Left main, provisional stenting, lithotripsy, rotapro
Learning Objectives
- To explore how to plan left main PCI
- To share a LIVE case using a two-stent strategy
- To understand how to use imaging to guide therapeutic options and procedure optimisation
