T wo Stent Strategy with DES and BVS for Left Main Bifurcation - - PowerPoint PPT Presentation

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T wo Stent Strategy with DES and BVS for Left Main Bifurcation - - PowerPoint PPT Presentation

Sep 01, 2022 298 likes •483 views

T wo Stent Strategy with DES and BVS for Left Main Bifurcation Treatment Indulis Kumsars, MD Latvian Centre of Cardiology Latvia Clinical Characteristics Male 69 y.o. Stable angina CSS II-III Old Q-MI anterior wall EF- 50%

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T wo Stent Strategy with DES and BVS for Left Main Bifurcation Treatment

Indulis Kumsars, MD Latvian Centre of Cardiology Latvia

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Clinical Characteristics

 Male  69 y.o.  Stable angina CSS II-III  Old Q-MI anterior wall  EF- 50%  PCI with DES LAD 2011

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LM before treatment

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LCX ostium before treatment

MLA 3.54 mm2

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PCI – Positioning of BVS

Cutting balloon 3.25 – 10mm BVS 3.5 – 12mm

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PCI – BVS post-dilatation

NC 3.5 – 8mm

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Result after BVS in LCX

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PCI – DES LM - LAD

Balloon 3.5 – 15mm DES 4.0 – 18mm

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Kissing balloon dilatation

Balloon 4.0 – 8mm - LAD Balloon 3.5 – 12mm – LCX POT 4.5- 8mm LM

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Final result

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IVUS in LCX after treatment

LCX body LCX just after bifurcation

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LM after treatment

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OCT in LCX

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OCT in LCX just after bifurcation

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OCT in LM

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Conclusions

 Strategy with DES+ BVS could be

effective treatment option in selected distal LM cases

 IVUS and OCT are helpful additional

tools in complex LM treatment