EBC - ON DEMAND
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.