Case summary
•73 year old male patient
•PMHx: DM type II, recurrent PEs
•Unstable angina
•EF 20%, Pulmonary HTN (60 mmHg)
•Moderate LMS, severe diffuse LAD disease, subtotal occlusion distal LCx bifurcation,RAC moderate disease
•MRI: LCx territory viable; LAD territory largely non-viable
•Meds: Rivaroxaban stopped 24 u before procedure
–Aspirin + clopidogrel
–VerifyNow test
Strategy
•Femoral access 7 Fr
•PCI of (sub) total occluded Lcx
•IVUS evaluation of LMS and ostial LCx disease +/- complex bifurcation PCI
Shooting date : 2016-07-08
Last update : 2021-06-09
wenliang X. Wonderful
Muhammad R. Good