Uncategorized cases
Imaging Guided Calcified LM PCI with Interactive Discussion about EXCEL Trial Results by Dr. Gregg Stone and Dr. John Puskas – November 2019

Case and Plan:
77 year-old male with stable class II angina and exertional dyspnea was noted to have calcified 90-95% left internal carotid artery stenosis on carotid duplex for ongoing neurological symptoms. A Cardiac Cath on November 18, 2019 as the part of pre-op evaluation for carotid endarterectomy revealed calcified severe 2V (RCA and LCx) and 90% distal left main disease with SYNTAX Score of 26, LVEF 60% and moderate AS (MG 15 mmHg, AVA 1.2 cm2). After Heart Team discussion, CABG was declined due to ongoing neurological issues & moderate AS and PCI was recommended. Patient is now planned for IVUS guided high risk PCI of calcified distal LM using rotational atherectomy and single crossover stent approach.

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