10 Dec 2025
Provisional stenting for a distal left main stenosis - LIVE Case
Provisional left main stenting after lesion preparation guided by IVUS
Recommended by PCR
Operators:
S. Al Shaikh, F. Bardooli
Procedural Analyst:
G. Stankovic
Summary
A 66-year-old male with preserved LV function, type II diabetes, and hypertension, presented with CCS and anterior ischemia, with a normal ECG. Photon-counting CT revealed a significant calcified stenosis of the distal left main and proximal LAD, confirmed by coronary angiography.
A stent was implanted in the proximal CX, followed by provisional LM-LAD stenting after lesion preparation with NC balloon and IVL, guided by IVUS at each step.
LIVE Educational Case from Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre - Awali, Bahrain
Navigate the video by moving your mouse over the chapter icon in the toolbar
Key moments
- 33:05–43:28 – Lesion preparation - IVL
- 51:20–54:28 – Left main - LAD stenting
- 24:00–31:20, 43:42–50:40, 58:20–1:01:50, 1:10:27–1:17:20 – IVUS at each step
Keywords: Distal left main stenosis, provisional stenting, IVUS, IVL
Learning Objectives
- Demonstrate the role of CT and intravascular imaging in left main assessment
- Illustrate step-by-step technique of provisional stenting strategy
- Emphasize imaging-guided optimisation for long-term outcomes
