SCAI Bifurcation Club Webinar Series: Procedural Approaches and Techniques for Complex Lesions-Ostial LAD Case

Video Transcription

Video Summary

The speaker presents a case of a 65-year-old female with multiple comorbidities who presented with acute coronary syndrome. The patient has end-stage renal disease, diabetes type 2, hypertension, multiple myeloma, and deep vein thrombosis. The angiogram shows calcified coronary vessels, stents in the circumflex and mid-LAD, and a chronic total occlusion of the right coronary artery. The speaker discusses the treatment options and suggests a robotic LIMA to LAD procedure as a good option. The panel discusses the severity of the lesions and whether to use a one-stent or two-stent approach. The speaker performs IVL for the LAD and then places a drug-coated stent from the proximal to the left main. The final angiogram shows a good result. The panel agrees with the one-stent strategy considering the patient's comorbidities and the risk of renal stenosis. The speaker also mentions a study that supports the use of a single crossover stent instead of a two-stent technique.

Asset Subtitle

S. Tanveer Rab, MD, FSCAI

Keywords

acute coronary syndrome

robotic LIMA to LAD procedure

one-stent approach

IVL

renal stenosis

Shockwave