04 Oct 2024
Optimising outcomes in treating multivessel disease - LIVE case
Calcified multivessel disease PCI under physiology and IVUS guidance
Summary
A 75-year-old male with hypertension, dyslipidemia and a lot of co-morbidities presented a positive echo stress test. The coronary angiography showed diffuse calcified disease on LAD, CX, OM1 and RCA. There is significant stenosis on ostial RCA, mid LAD, mid CX and OM1.
After physiology assessment (virtual FFR and iFR) and the IVUS, there was only significant stenosis on ostial RCA and mid LAD.
The operators implanted 1 stent in ostial RCA and 2 stents in proximal and mid LAD with a good lesions preparation (NC balloon and IVL). Watch the procedure guided by IVUS-NIR and physiology at each important step.
LIVE Educational Case from Liverpool Hospital - Sydney, Australia
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Key moments
- Physiology assessment
- 34:03-47:10 - IVUS-NIR
- 48:40-54:40 - IVL step-by-step
- lesions preparation
- 1:01:24-1:12:33 - LAD post dilatation
Keywords: Multivessel disease, calcified lesions, IVL, iFR, virtual FFR, IVUS, NIR-Scoring, balloon
Learning Objectives
- To learn how to use coronary physiology to provide a functional syntax assessment.
- To learn how to use coronary physiology pressure-wire assessment to guide revascularisation strategy in lesion-specific assessment.
- To understand the importance of intra-coronary imaging to optimise PCI results in pre and post PCI.
