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Solaci at EuroPCR. Complex left main PCI Patient presentation

Solaci at EuroPCR. Complex left main PCI Patient presentation. Complex eft main bifurcation PCI Male, VZM, 54. Risk factors DM2 (insulin-dependent) Hyperlipidaemia Smoker Life style Active Psychological status Normal, no cognitive impairment. No Prior clinical history.

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Solaci at EuroPCR. Complex left main PCI Patient presentation

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  1. Solaci at EuroPCR. Complex left main PCIPatient presentation

  2. Complex eft main bifurcation PCIMale, VZM, 54 Risk factors • DM2 (insulin-dependent) • Hyperlipidaemia • Smoker Life style • Active Psychological status • Normal, no cognitive impairment

  3. No Prior clinical history Clinical presentation • One month history of episodes of chest pain at rest and during exertion (15-20 min) • Admitted after an episode of chest pain at rest with no dynamic ECG changes

  4. Laboratory investigations Biomarkers: • TnI: <0.01, CK: 130 (1st ) • TnI: <0.01, CK: 113 (2nd) Creatinine: 0.88 gr/dl Clearance creatinine: 97 ml/min Hb: 16 gr/dl Platelets: 194 000 Total cholesterol: 217 gr/dl HDLc: 33 gr/dl LDLc: 44.4 gr/dl

  5. Non-invasive evaluation • ECG: sinus rythm, 75 bpm, normal repolarisation • Exercise test: ECG positive with ST depression in inferior leads. Clinically

  6. Baseline angiography Medina 0-1-0

  7. Baseline angiography

  8. Risk evaluation Angiographic Syntax score = 12 Syntax score II: • PCI: 18.0 (PCI 4 Year Mortality: 2.5 %) • CABG: 16.2 (CABG 4 Year Mortality: 2.2 %)  Treatment recommendation: equipoise for CABG or PCI STS score = 0.362 EuroSCORE (mortality logistic)= 1.54

  9. Key clinical data & angiographic reference 54 year old male. Diabetic, smoker. Progressive angina with positive exercise test . Severe stenosis ostial LAD

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