Case and Plan:
64 yrs, M, known CCS
Presented with CCS class IV angina with +HS-Tn
CAD Risk Factors
Hypertension – controlled
Hyperlipidemia – controlled
Ex-Smoker, + F/H
HbA1c:5.2/ LDL:54/ CRP:2.6/ SCr:1.0
Clinical Variables
s/p multiple PCIs in last 12 yrs, echo LVEF 65%
Medications
Aspirin, ISMN, Amlodipine, Atorvastatin
Cath: Cath on April15th 2025 revealed 2 V CAD ISR; 90% LCx-OM1, 70-80% mid LAD and D2 multilayer DES ISR, LVEF 60% and Syntax score 18. FFR <0.80 in LCx and LAD. Pt underwent CBPTCA+DCB to LCx-OM1 and did well. Now planned for HD-IVUS guided complex PCI of LAD & D2 ISR with stent-less strategy using RotaCut approach followed by DCB.
