title: Bioresorbable vascular scaffolds for LMCA with double vessel disease under IVUS guidance.
abstract: An 80-year-old male patient, presented with chest pain. ECG showed ST elevation in leads V2 to V4 and T wave inversion in leads V2-V6. Check angiogram revealed ostial LMCA 70% lesion & mid-LAD 90% lesion and LCX proximal 80% lesion. Predilatation of LMCA lesion was done with 2.0 × 12 mm NC Trek balloon and the LAD lesion with 2.0 × 12 mm and 2.5 × 08 mm (NC Trek balloons). Prestenting IVUS (Intravascular ultrasound) was done with Atlantis SR pro 40 MHz 3.6 Fr catheter. IVUS showed the LAD to have a minimal lumen area of 2.6 sq mm with 90% fibrotic plaque and a vessel size of 2.5mm and the LMCA to have a minimal lumen area of 8.8 sq mm with 70% fibrotic plaque and vessel size of 3.8mm. Mid-LAD stenting was done with 2.5 × 28 mm Absorb Stent (BVS). Predilatation of LCX lesion was done with 2.5 × 08 mm NC Trek balloon. Then stenting was performed with 3.0 × 28 mm Absorb Stent (BVS). Check angiogram showed edge dissection proximal to the BVS Stent which was covered with 3.0 × 12 mm Xience Xpedtion Stent (DES). Then LMCA Stenting was done with 3.5 × 12 mm Absorb Stent. Post dilatation was done with 4.0 × 08 mm NC Trek balloon. Post Stenting LMCA - LAD IVUS was done. LMCA and LAD Stents were well opposed without any dissection or residual stenosis. TIMI III Flow was achieved in the final results.
authors.affiliation: Senior Interventional Cardiologist, Sunshine Heart Institute, Secunderabad, Hyderabad, Telangana, India. Electronic address: drsk.shi@gmail.com.
authors.forename: Sridhar
authors.initials: S
authors.lastname: Kasturi
authors.affiliation: Interventional Cardiologist, Sunshine Heart Institute, Secunderabad, Hyderabad, Telangana, India.
authors.forename: Vinoth Kumar
authors.initials: VK
authors.lastname: Vilvanathan
mesh_terms: D020341:Absorbable Implants; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D004562:Electrocardiography; D006801:Humans; D008297:Male; D015607:Stents; D018084:Ultrasonography, Interventional
keywords: Bioresorbable vascular scaffold; Double vessel disease; IVUS; LMCA