Скачать с ютуб Case 168: Manual of PCI - CT and FFRangio guided PCI в хорошем качестве

Case 168: Manual of PCI - CT and FFRangio guided PCI

A patient presented with exertional dyspnea and was found to have anterior ischemia on nuclear stress testing. Coronary CT angiography showed a severe lesion in the proximal LAD with an area of circumferential calcification. Estimated stent length was 28 mm with 2.8 mm distal reference and 3.3 mm proximal reference diameter. These findings were confirmed on coronary angiography. After predilatation a 3.0x30 mm stent was deployed from the left main into the mid LAD, jailing the circumflex and the first diagonal. FFR angio of the diagonal was 0.89. IVUS showed under-expansion of the distal left main stent that was successfully treated with intravascular lithotripsy. The ostium of the circumflex was “pinched”, hence kissing balloon inflation was done with a 3.0 mm balloon in the LAD and a 3.5 mm balloon in the circumflex with an excellent result. FFRangio of the circumflex was 0.93. The patient had an uneventful recovery and his symptoms resolved.