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Patient history
- Male, 80 years-old
- High blood pressure
- Stable angina, normal EKG and echocardiography
- Large inferior ischemia on cardiac MRI (4-5 segments/17)
Description of lesion
- Mid LAD Occlusion
- Calcification - JCTO score 1
- Good Collaterality from RCA
- Ambiguous origin with branchs
- Two vessel disease, Circ already treated (stent deployment needed very high pressure)
Description of procedure
- LAD recanalisation without post-dilatation stenting
- Re-occlusion followed by Second recanalisation and DES stenting
- Antegrade approach, with AL2 6 french, Finecross and fielder XT
- Bilateral injection (1 femoral, 1 radial)
- Laser as first intention because of difficulty to open the circumflex artery
Devices used
- ELCA laser ablation catheter (Spectranetics)
- CVX-300
Learning Points:
- Role of simple balloon angioplasty
- How to access and treat a proximal and mid LAD occlusion
Shooting date : 2014-07-01
Last update : 2021-06-09
Last update : 2021-06-09
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jehangeer H. RISK OF PERFORATION?
Vinod N. Thanks
Mohamed amine R. RCA , not LAD