21 May 2025
Complex multivessel disease - LIVE Case
CT- and IVUS-guided complex bifurcation PCI
Operators:
N. Gonzalo, J. Escaned
Procedural Analyst:
F. Bardooli
Summary
An 89-year-old male patient presented with stable angina, preserved LV function and some risk factors such as hypertension and diabetes. CT scan and angiography revealed occlusion of proximal RCA and bifurcation lesions on LAD and circumflex (medina 1,1,1). Operators treated the bifurcation lesions with provisional stenting.
Regarding the LAD-DI, they prepared the lesion with IVL, guided by CT/angio co-registration and IVUS. They finally confirmed the result by FFR.
LIVE Educational Case from Hospital Clínico San Carlos - Madrid, Spain
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Key moments
- 17:50-19:40 - Cx bifurcation PCI with provisional stenting
- 20:40-24:13 - CT analysis
- 26:03-44:44 - CT/angio co-registration
- 1:02:57-1:08:39 - Dual microcatheter liner for diagonal wiring after LAD stenting
- 1:17:53-1:20:31 - Post-procedural analysis
Keywords: non-left-main bifurcation PCI with provisional stenting, IVL, CT/angio co-registration, IVUS, FFR
Learning Objectives
- To share how CT information can be used to guide treatment of multivessel disease
- To learn how to use intracoronary imaging to assess plaque preparation and stent optimisation
- To share how to assess the result of PCI using physiology
