Coronary angioplasty : Master the Complex

Program (GMT +2)

Clinical case presentation

• 79 year old female patient
• No significant past medical history
• Presented with stable angina
• Myocardial perfusion imaging revealed a large anterior perfusion defect
• EF : 60%
• Coronary angiography : severe LMS trifurcation lesion /additional severe stenoses prox LAD/D1 bifurcation and OM2.

Case strategy

• Syntax I score : 28
• Syntax II score :
  - PCI : 37.9 (PCI 4-yr mortality 12.8%)
  - CABG : 34.5 (PCI 4 yr mortality 9.7%)
  Recommendation : CABG or PCI
• Patient preferred PCI option, Heart team in agreement
• Planned PCI strategy
  - Pre-intervention IVUS evaluation of LAD lesion and LMS trifurcation
  - PCI of LAD and LCx lesions
  - PCI of LMS trifurcation lesion (provisional or 2-stent technique)
  - IVUS to evaluate/optimise the PCI result

Case diagnostic image

Educational objectives

• Improve coronary angioplasty knowledge (techniques and approach strategies)
• Step-by-step treatment of complex left main trifurcation lesion (single vs double stent strategy / stent design and sizing in LMS PCI)
• Discuss the choice of a material for specific patients (short DAPT, early healing) and specific lesions (calcified, left main, bifurcation...) in your practice
• The role of intracoronary imaging modalities in guiding and optimising the PCI result
• Compare techniques and approach strategies of different experts

Audience

This web symposium is dedicated to interventional cardiologists interested and/or specialized in coronary angioplasty.
A prerequisite for attendees is an initial knowledge and practice of angioplasty.