Provisional stenting with a scaffold stent and DCB in calcified left main bifucation - LIVE Case

A 59-year-old male presented with CCS for three months, with diabetes and normal LV function (72%). Coronary angiography showed a calcified left main stenosis (Medina 1,1,1) and diffuse calcification of the proximal and mid LAD. The LCX QFR was 0.86.

Treatment included extensive lesion preparation with lithotripsy and scoring balloons on the left main and LAD, and scoring balloon followed by DCB on the proximal LCX. Two DynamX bioadaptor scaffold stents were then implanted in the LAD and from the left main to the LAD. The PCI was guided by OCT and stent enhancement.

LIVE Educational Case from Cardiac Vascular Sentral - Kuala Lumpur, Malaysia

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Key moments

• 08:03–14:23 – Imaging analysis
• 28:27–37:52 – LithiX–IVL balloon step by step
• 38:57–50:19 – Scoring balloon stenosis preparation
• 43:04–54:50 – OCT run
• 1:02:00–1:09:50 – Stent enhancement at the different steps of the PCI

Keywords: Left main bifurcation PCI, OCT, Stent enhancement, Scoring balloon, LithiX-IVL, DynamX bioadaptor scaffold stent