title: How to do it?: percutaneous treatment of a severely stenosed and calcified left main stem bifurcation.
abstract: METHODS
  A frail 87 year-old lady presented with rest angina associated with widespread ECG change and troponin release. She failed attempts at medical therapy and therefore was referred for coronary intervention on the basis that she was not a surgical candidate.
  
  
  METHODS
  Coronary angiography demonstrated heavily calcified coronary arteries with critical disease at the distal left main stem bifurcation extending into the proximal segments of both LAD and circumflex.
  
  
  METHODS
  Acute coronary syndrome with extensive calcific coronary artery disease in the left main stem bifurcation.
  
  
  RESULTS
  Sequential rotational atherectomy of the left main stem bifurcation followed by 'Y'-stenting using three Xience Prime drug eluting stents.
authors.affiliation: Green Lane Cardiovascular Service, Auckland City Hospital, Park Road, Grafton, Auckland 1142, New Zealand. Electronic address: tjw123@me.com.
authors.forename: Timothy
authors.initials: T
authors.lastname: Watson
authors.affiliation: Green Lane Cardiovascular Service, Auckland City Hospital, Park Road, Grafton, Auckland 1142, New Zealand.
authors.forename: James T
authors.initials: JT
authors.lastname: Stewart
authors.affiliation: Green Lane Cardiovascular Service, Auckland City Hospital, Park Road, Grafton, Auckland 1142, New Zealand.
authors.forename: Mark W I
authors.initials: MW
authors.lastname: Webster
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*; D000369:Aged, 80 and over; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011859:Radiography; D015607:Stents; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Bifurcation; Calcification; Left main stem disease; Rotational atherectomy