Left main and LAD bifurcation - LIVE Case

A 59‑year‑old man with a history of STEMI in 2019 (Cx PCI), as well as hypertension and dyslipidemia, presented with CCS class III angina. Coronary angiography revealed a chronic total occlusion (CTO) of the OM2 and a calcified ostial lesion of the LAD and first diagonal branch.

The procedure consisted of LM–diagonal stent implantation and treatment of the first diagonal with a sirolimus‑eluting DCB. The PCI was guided by IVUS.

LIVE Case from Groote Schuur Hospital Cape Town

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Key moments

• 08:20–12:07 – Procedural analysis
• 24:47–27:20 – IVUS run at the beginning (LAD)
• 59:49–01:10:10 – Rewiring the digonal and CX
• 01:21:10–01:24:23 – DCB in the diagonal
• 01:28:44–01:33:03 – IVUS run at the end (final IVUS)

Keywords: Left main bifurcation, non left main bifurcation, provisional stenting, DCB, IVUS