Rotablation and stent placement in an unprotected left main coronary ostial stenosis.
We report the case of a patient with postinfarction rest angina, high grade ostial left main (LM) stenosis, and right and circumflex coronary occlusion. Coronary artery bypass was performed, yet all grafts failed within 2 months of surgery. We elected to proceed with coronary intervention on the ostial LM lesion with intracoronary ultrasound lesion characterization and percutaneous cardiopulmonary bypass support. Rotablation followed by stent deployment achieved a successful angiographic outcome with no associated clinical complications. At 1-year follow-up, the patient remains stable with evidence of mild restenosis. Interventional approaches in unprotected LM coronary stenoses are associated with high procedural risk. Combined atherectomy/ablation with stent placement guided by intracoronary ultrasound may enhance procedural and long-term outcome.
Koller
P T
PT
St. Paul Heart Clinic, MN 55102, USA.
Mooney
M R
MR
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D017225:Atherectomy, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D012008:Recurrence; D015607:Stents