ABSTRACT
Case # 10974/02 is illustrated by slides 1-5 ( frames 1-12). Frames 1 and 2 show a moderate disease of the left main, extending into the proximal left anterior descending (LAD) with severe ostial disease of the circumflex. This particular anatomy demands stenting for both branches. The technical approach in this situation varies according to the experience of the operator. This relatively short left main is potentially suitable for V-stenting. In this particular case, we elected to use the crush technique. Frame 3 demonstrates both stents in place, while frame 4 demonstrates final kissing inflation. This case represents one of our early experiences with the crush technique, and the procedure was not preceded by aggressive cutting balloon pre-dilatation, particularly of the ostium of the circumflex. Frames 5-7 show deployment of an additional stent at the ostium of the left main, while frame 8 shows the final result. Despite the lack of what we call ‘optimal lesion preparation’, we were rewarded by a good follow-up result with absence of any recurrence, as demonstrated in the 9-month follow-up ( frames 9-12).
