16 May 2024
Imaging-guided PCI for stent failure - LIVE case
LAD stent restenosis treated by IVL and DCB guided with OCT
Operators:
J. Escaned, N. Gonzalo
Procedural Analyst:
T. Johnson
Summary
An 86-year-old male with PAD, a stroke in 2007, and a history of LAD PCI in 2006, presented with unstable angina due to LAD stent restenosis involving D1 and D2, with preserved LV function.
Guided by OCT, the operators performed stenosis preparation using IVL, treated the distal LAD with a stent, and addressed the in-stent restenosis with a paclitaxel DCB.
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LIVE Educational Case from Hospital Clínico San Carlos, Madrid - Spain
Key moments
- 18:20-19:20 - QFR
- 20:30-25:19
41:30-46:45
01:12:57-01:20:38 - OCT runs - 26:15-39:40 - IVL step-by-step
- 59:30-01:09:40 - DCB angioplasty
- 01:27:13-01:29:06 - Procedural analysis
Keywords: In stent restenosis, OCT, Paclitaxel DCB, IVL, QFR
Learning Objectives
- To learn how to manage of in-stent restenosis
- To understand the value of intracoronary imaging in this context
- To learn the tailored strategy for in-stent restenosis and de novo lesions
