05 Oct 2024
Complex calcified left main bifurcation - LIVE case
Provisional stenting of left main distal calcified stenosis guided by IVUS
Summary
An 82-year-old woman with diabetes, hypertension, a history of Micra and RCA PCI 2 years later, was admitted for NSTEMI. The coronary angiography showed a very calcified distal left main stenosis, a significant and calcified ostial LAD stenosis (medina: 1 1 0), confirmed by IVUS. She has a preserved LV function.
Watch the operators prepare the lesion with a rotablator (Burr 1.75) and a scoring balloon, and perform a provisional stenting with a stent from the ostial left main to proximal LAD. All the steps were IVUS-guided.
LIVE Educational Case from Cardiac Vascular Sentral - Kuala Lumpur, Malaysia
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Key moments
- 05:55-18:00 - Angio analysis
- 19:32-26:47 - Rotapro step-by-step
- 26:48, 35:00 - IVUS runs between every step
Keywords: Left main bifurcation stenosis, Rotablator, Scoring balloon, IVUS, provisional stenting
Learning Objectives
- To learn how to identify lesions which are suitable for rotational atherectomy
- To learn how to perform rotational atherectomy safely and effectively
- To learn how to use imaging to guide treatment of complex calcified anatomy
