Case and Plan:
Patient Demographics:
69 yrs, Male
Present Clinical Presentation:
Presented with CCS Class III angina
CAD Risk Factors:
Hypertension, Hyperlipidemia, NIDDM,
Family history.
LDL: 46, SCr: 1.1, HbA1c: 7.0
Clinical Variables:
Abnormal CCTA with 2VD,
Prior PCI (2008): RCA (TAXUS × 3) and LPL (TAXUS 2.75/32), EF 60% on echo.
Medications:
Aspirin, Clopidogrel, Rosuvastatin, Metoprolol, Ranolazine, Pioglitazone, Losartan
Cath:
Cardiac cath on 4/9/2026 @MSH revealed 80-90% severely calcified ISR lesion in mid to distal RCA, and a 90% calcified ISR lesion at the LPL bifurcation with native
OM disease. SYNTAX Score 18. RCA ISR lesion was treated with RA + IVL + 2 DES.
Plan:
Now planned for IVI-guided PCI for LPL ISR and OM bifurcation lesion.
