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Case summary

-Age: 77 year old
-Gender: male
-NIDDM; Hypertension; Dyslipidaemia
-Previous pacemaker implantation
-Known IHD:
-1980: inferior MI (no details)
-2014:   preserved LV function with   infero-basal hypokinesis
-Known Carotid Artery Disease:
-70% right internal carotid
-100% left internal carotid
-Pulmonary oedema with uncontrolled BP and mild troponin rise
-ECHO: LVEF 40%, inferior akinesis
-LM: moderate stenosis distally (MLA 7.64 mm2, FFR 0.87)
-LAD: severe stenosis LAD-D1 bifurcation (MLA 2.54 mm2), FFR catheter could not cros
-Cx: critical 90% calcified stenosis proximally
-RCA: CTO proximally with septal collaterals from LAD
-SYNTAX score: 32
-Turned down for surgery

Strategy

ACCESSES:

-RFA: XB 3.5 7Fr
-LFA: IABP (LVEF 40%, LM disease with RCA CTO à last remaining vessel)

APPROACH:

-Predilatation of Cx
-Rotational atherectomy of LM-LAD and LM-Cx (1.5 mm burr)
-Predilatation of LM-LAD and LM-Cx with NC balloons +/- scoring balloon
-IVUS
-Stenting (two-stent strategy: DK crush vs culotte)
-Post-dilatation with NC balloons (POT, kissing)
-IVUS
-Evaluation of CTO PCI on RCA at a later stage

Protocol: OptiRAY (Ioversol)

-Concentration: 350 mgl/mL
-Volume: 350 mL
Shooting date : 2017-01-26
Last update : 2021-06-09

Suggestions

Wednesday, July 5th 2023 from 06pm to 07pm (GMT+2)
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Istanbul : Wednesday, July 5th 2023 from 08pm to 09pm (GMT+2)
Moscou / Dubaï : Wednesday, July 5th 2023 from 09pm to 10pm (GMT+2)
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Wednesday, May 22nd 2024 from 03pm to 04pm (GMT+2)
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Istanbul : Wednesday, May 22nd 2024 from 05pm to 06pm (GMT+2)
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DanGER shock trial results and the significance to reduce adverse events

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Reykjavik : Monday, September 26th 2022 from 04pm to 06pm (GMT+2)
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Sydney : Tuesday, September 27th 2022 from 03am to 05am (GMT+2)
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Quand le patient et l’angiographie racontent des histoires différentes

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Monday, October 30th 2023 from 05pm to 06pm (GMT+1)
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Paris / Berlin : Monday, October 30th 2023 from 05pm to 06pm (GMT+1)
Istanbul : Monday, October 30th 2023 from 06pm to 07pm (GMT+1)
Moscou / Dubaï : Monday, October 30th 2023 from 08pm to 09pm (GMT+1)
Bangkok : Monday, October 30th 2023 from 11pm to 12am (GMT+1)
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