19 Dec 2024
Complex non left main bifurcation PCI - LIVE case
Two-stent strategy for non-LM bifurcation: Culotte technique
Summary
A 71-year-old male presented with angina (CCS 2), normal left ventricular function, and mitral stenosis. Coronary angiography revealed severe ostial stenosis of the circumflex artery and a significant LAD/diagonal bifurcation lesion (Medina 0.1.1).
The operators performed balloon valvuloplasty to treat the mitral stenosis, followed by LAD/diagonal PCI. Lesion preparation was carried out using a cutting balloon due to fibrosis detected on OCT. Culotte stenting was then performed with a 2.75 × 28 mm stent in the diagonal branch and a 3.0 × 28 mm stent in the LAD, guided by stent enhancement imaging and OCT.
Watch the procedure!
LIVE Educational Case from National Heart Centre at Royal Hospital - Muscat, Oman
Navigate the video by moving your mouse over the chapter icon in the toolbar
Key moments
- 7:00-10:30 - Imaging analysis
- 24:37-30:30 - Lesion preparation with cutting balloon
- 31:40-1:04:30 - Step-by-step Culotte stenting
- 1:05:30-1:14:24 - OCT guidance
Keywords: Non LM bifurcation, Culotte stenting, Cutting balloon, OCT
Learning Objectives
- To learn how to choose the optimal technique
- To learn when and how to treat the side branch
- To learn when adjunctive diagnostic tools can be helpful
