Intravascular Imaging with Bifurcation PCI-Case Presentation of IVUS Guided LM Bifurcation Stenting

Video Transcription

Video Summary

The video transcript summarizes a case presentation of IVAS-guided left main bifurcation stenting. The patient is a 50-year-old man with exertional chest pain and shortness of breath. Initial examination reveals elevated BMP and electrocardiographic changes indicating unstable angina and an old anterior myocardial infarction. Baseline angiogram shows diffused lesions in the RCA and left main bifurcation involving the diagonal and circumflex arteries. The syntax score is high, indicating complexity. The patient's family opted for staged PCI due to reluctance for CABG. The first stage involved PCI on the RCA using IVAS guidance and a 2.5 cutting balloon for calcification lesions. Three drug-eluting stents were inserted. The second stage involved left main bifurcation stenting using ECMO support and IVAS guidance. Lesion preparation and provisional stenting were performed. The final result showed optimal stent expansion. The post-procedure IVAS imaging revealed minimum stent areas above criteria. The importance of imaging in complex and modification PCI is emphasized. The transcript concludes with a discussion on the value of different imaging techniques, such as OCT and IVAS, and the need for meticulous planning and execution in bifurcation stenting.

Asset Subtitle

Jun-Jie Zhang, MD, FSCAI

Keywords

IVAS-guided stenting

left main bifurcation

unstable angina

drug-eluting stents

imaging techniques

PCI procedure