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Extreme Left Main Stem Calcification

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Extreme Left Main Stem Calcification

European Bifurcation Club 2019, EBC 2019 – Barcelona, Spain

AWARD CASE SESSION – VOTING

Extreme Left Main Stem Calcification: Rotashock combination therapy

Author: Peter O’Kane, MD FRCP, Royal Bournemouth Hospital, UK

 

CLINICAL PRESENTATION

  • 79 year old lady
  • Unstable angina, Troponin 250, eGFR 38
  • Exertional dysopnea for several months
  • Echo: LVEF 45%with akinetic apex but good regional wall motion elsewhere

PCI STRATEGY

  • 7F EBU3.5 Guide
  • RT wire LAD & SB wire LCx
  • Sapphire 2.0×20 balloon not cross LAD •Rotational atherectomy
  • 2 stent technique – culotte of DK Crush • IVUS guided throughout

 

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