Case and Plan:
Patient Demographics
55 yrs, M
CAD Risk Factors
Hypertension – controlled
Hyperlipidemia – controlled
SAQ-7 score: 90, ESRD on HD
HbA 1c:6.5/ LDL:73/ CRP:6.6/ SCr:6.4, eGFR:8
Present Clinical Presentation
Presented with new onset CCS class I angina and high Cat+ score of 4432 with +ctFFR of LAD & RCA
Clinical Variables
No known CAD, echo LVEF 60%
Medications
Aspirin, ISMN, Carvedilol, Hydralazine, Pravastatin, Renal Drugs
Cath: Cath on December 5th 2025 revealed calcific 2 V CAD with multiple lesions of LAD and RCA with syntax score 22 and LVEF 60%. Pt underwent successful RotaDES PCI x2 of RCA.
Clopidogrel 75mg daily added.
Plan: Now planned for HD-IVUS guided staged complex PCI of calcified RCA using rotational atherectomy and 2 DES
