Case and Plan:
Patient Demographics
71 yrs, M
Present Clinical Presentation
Presented with CCS Class I angina and +stress MPI for multi-vessel ischemia
Clinical Variables
No known CAD, echo revealed LVEF 55%
CAD Risk Factors
Hyperlipidemia – controlled
Hypertension – controlled
NIDDM – controlled
SAQ-7 score: 89, BMI: 23Kg/m2
HbA1c:6.4/LDL:57/CRP:1.6/SCr:1.4, eGFR:52
Medications
Aspirin, Clopidogrel, Ramipril, Lopressor, Metformin XL, Simvastatin, Ezetamibe
Cath: Cath on August 11th 2026 revealed calcific 3 V CAD; 80% pLAD and 70% D1 bifurcation,
80% pLCx, 80-90% RCA with syntax score 42 and LVEF 55%. After Heart team discussion CABG
was declined and recommended PCI. Pt underwent RotaDES PCI of LAD/Diagonal using 2 synergy
DES and DCB and did well.
Plan: Now planned for HD-IVUS guided staged PCI of tortuous calcified RCA
using RotaCut approach and DES.
