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.

comments

Leave a Reply

Your email address will not be published. Required fields are marked *

suggestion
Suggestions
OCT Guided Complex Intervention of LM and Long Calcified Aneurysmal LAD – January 2020
Tags: | |
Views 64

Case and Plan: 76-year-old female presented with new onset CCS Class III angina with positive SPECT MPI for mild lateral ischemia. A Cardiac Cath on January 6, 2020 revealed 3 V + LM CAD: 70% distal LM, 80% proximal LAD/D1 bifurcation, 80% long calcified aneurysmal mid LAD, 80% LCx-OM1, SYNTAX Score of 35 and LVEF […]


OCT Guided PCI of Calcified LAD Bifurcation using 2-Stent + OA – December 17, 2019
Views 638

Case and Plan: 67-year-old male controlled NIDDM, presented with CCS Class I angina and positive stress echo for multi vessel ischemia. A Cardiac Cath on August 9, 2019 revealed 3 V CAD: calcified 80% mid LAD and D2 bifurcation, 70% distal LAD, CTO mid RCA and CTO proximal LCx, SYNTAX Score of 38 with moderate […]


Left SFA CTO – Oct. 2019
Views 337

68 year old female with HTN, DM, HLD who presents with life style limiting claudication, that has progressed to pain a rest. She had a non invasive workup done revealing abnormal ABI. She had a subsequent peripheral angiogram done revealing mid Left SFA total occlusion and referred for further intervention.


Recanalization of a complex RCA CTO using Antegrade/Retrograde Approach – Oct 2019
Views 788

50-year-old female with multiple CAD risk factors presented with new onset CCS Class II angina for two months and stress echo revealed moderate inferior ischemia. A Cardiac Cath on October 7, 2019, performed at an outside hospital, revealed 1 V CAD: CTO of prox RCA, which fills via collaterals from left system with non obstructive […]