EBC - ON DEMAND
Short LM – Problem of ostial coverage
European Bifurcation Club 2019, EBC 2019 – Barcelona, Spain
COMPLICATION CASES
Devil wears Prada: LM stenting, problem of ostium coverage
Author: Himanshu Gupta, MD, DM, PGI Chandigarh, India
CLINICAL PROFILE
- 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
PROBLEM
- 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
LEARNING POINTS
- 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