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Short LM – Problem of ostial coverage


Short LM – Problem of ostial coverage

European Bifurcation Club 2019, EBC 2019 – Barcelona, Spain


Devil wears Prada: LM stenting, problem of ostium coverage

Author: Himanshu Gupta, MD, DM, PGI Chandigarh, India



  • 50 Years Male
  • HTN, No DM, Former Smoker
  • 1 episode of Syncope 10 days back
  • ECG – Normal with no baseline ST changes
  • Evaluated at OSH and found to have CAD
  • LVEF- Normal LV function with no baseline RWMA or valve disease


  • After FKB the LAD wire position was lost as the balloon got stuck on the wire
  • LAD rewired with another wire
  • Position of the fresh LAD wire in doubt??
  • LCX wire is good–Maybe, we have done a FKB already


  • Short LM and abnormal take off can cause problems
  • FKB not mandatory in provisional SB strategy
  • If u KISS – It should be good and safe
  • Rewiring always after POT – But be careful
  • Use dual lumen catheter to wire SB if in doubt
  • Never do POT on SB wire
  • Use Guide extension to prevent LSD
  • Angiographic follow up if possible


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