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Provisional stenting strategy in Left main

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Provisional stenting strategy in Left main

European Bifurcation Club 2014, EBC 2014 – Bordeaux, France

CASES: TIPS & TRICKS AND COMPLICATIONS

Provisional stenting strategy in Left main

Author: Carlos Garcia Alonso, Institut Cardiovasculaire Paris Sud, France

 

CASE

  • Male, 62 y.o.
  • Risk factors:
    • HTN
    • DLP
    • De novo DMZ
  • Prior clinical history
    • Stable angina in 2010. DES implanta-on in the mid RCA
  • Current clinical presentation: ACS-NSTE
  • Clinical data: Weight 90.0 kg, Height 170 cm, BMI 31 kg/m2. Creatinine clearance 96 mL/min.

CONCLUSION

  • Rare complication. More frequent in the sevng of complex lesions and certain stent planorms.
  • Suspect after abrupt material manipulation following a stent deployment. DANGER when treating LM:
    • Careful withdrawal of the stent balloon whith a prisoner guide.
  • This complication can be difficult to assess only by angiographic imaging. Digital enhanced stent visualization can help.
  • Careful postdilation of the compressed segment and deployment of an additional stent should be performed in order to ensure an optimal mechanical result.

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