FFR- and IVUS-guided PCI of a long and calcified LAD lesion - LIVE case

A 71‑year‑old man with hypertension and dyslipidemia presented with CCS class II angina and three‑vessel coronary artery disease. Functional assessment included CT‑derived micro‑FFR, angiography‑based FFR, and stress myocardial scintigraphy. The only hemodynamically significant lesion was a long, calcified lesion of the LAD.

Lesion preparation was performed with intravascular lithotripsy (IVL), followed by implantation of two stents in the LAD. The PCI was guided by IVUS and FFR (using papaverine) both before and after the procedure.

LIVE Educational Case from Sant'Andrea University Hospital - Rome, Italy

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Key moments

• 37:20 - 41:54 - IVUS run
• 45:15 - 52:34 - IVL technique
• 1:11:00 - 1:17:03 - FFR with papaverine
• 1:24:20 - 1:27:06 - Procedural analysis

Keywords: IVUS, IVL, FFR, Calcified non bifurcation LAD