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Identification and Treatment of a Special LMCA Bifurcation Lesion. Liu Xuebo. Zhongshan Hospital, Fudan University Shanghai Institute of Cardiovascular Diseases. Case presentation. 56-year-old man Effort chest pain for 5 year , aggravating 4 months
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Identification and Treatment of a Special LMCA Bifurcation Lesion Liu Xuebo Zhongshan Hospital, Fudan University Shanghai Institute of Cardiovascular Diseases
Case presentation • 56-year-old man • Effort chest pain for 5 year,aggravating 4 months • Previous LAD PCI 12 months before this re-admission • Smoking and hyperlipidemia for coronary risk factors 12 month FU coronary angiography (2009-7-7)
Index angioplasty(2008-7-8) Final angiographic findings
Proximal part of LM stent Ostial LAD Middle LM Distal LM stent Lad-LM IVUS imaging Proximal LM
12 Mon FU coronary angiography (2009-7-7) After balloon dilatin, I performed IVUS for ostial LCX lesion
What & Why happened at LMCA bifurcation location during Index PCI procedure?
Index angioplasty(2008-7-8) Crosswire NT guidewire 2.5*20mm Ryujin balloon
Index angioplasty(2008-7-8) Partner 2.5*36mm
Index angioplasty(2008-7-8) Partner 3.0*24mm Partner 3.5*24mm --- 14atm
Index angioplasty(2008-7-8) Kongon 3.5*15 in LAD Ryujin 2.5*20mm in LCX After stent cross-over LCX
Index angioplasty(2008-7-8) After Kissing balloon dilation
Index angioplasty(2008-7-8) Maverick 3.0*15mm
Index angioplasty(2008-7-8) Final angiographic findings
12 Mon FU coronary angiography (2009-7-7) Excel 3.5*18mm—18atm
12 Mon FU coronary angiography (2009-7-7) Apex 3.0*15 mm in LAD at 10atm Stent balloon in LCX at 12atm
12 Mon FU coronary angiography (2009-7-7) Final angio findings
Questions?? • Which step maybe is wrong in this case? • How often does it happen? • How to avoid it during procedure? • Angiography is blind on this complication?