LAD-D2 Bifurcation Lesion PCI using 2-Stent Technique - CCC Live Oct 2016

65 year-old diabetic male presented with new onset class II angina and a stress echo revealed apical and mid inferior wall ischemia. A Cardiac Cath on August 2, 2016 revealed 3V CAD: 70% RCA-RPL1, 80% proximal-mid LAD, 80% D2 LAD bifurcation, 80% LCx-OM1 and 70% LCx-LPL with normal LVEF; SYNTAX Score of 25. Patient underwent Heart Team discussion and then opted for complex multi-vessel PCI. Patient continued on aggressive CAD risk factor modification and maximal medical therapy. Patient is now planned for LAD-D2 bifurcation lesion PCI using dedicated 2 stent technique.
Date: October 2016
Broadcast live from: Mount Sinai Hospital
Operators: Dr. Samin Sharma and Dr. Annapoorna Kini
Modetator: Dr. Sameer Mehta

[@kailashchobisa6468]

Good sir 👍 in 2006-2008 I was with ur Cath Lab in Jaipur sir

[@laxu49]

In patients like these, we routinely use dapt and I believe that’s what the guidelines suggest. Can you please share why this patient was not given dual antiplateletes? Thank you

[@TheGucio07]

Nice job, great team. Congratulations and thank you for very educational case. I can see, that minicrush technique is routine in your 2-stent strategy. I got two questions: Did you perform POT inflation after kissing? I didn't saw this on the film. How with the distal stent? Don't you think, that is underexpanded in the middle?

[@mustafatopuz2602]

What about mid portion of LAD (between two stent ) spasm or atherosclerosis? IVUS ? Nitroglycerin?

[@dramolchavhan935]

In cullot side branch is stented first and significant portion of side branch stent come in proximal main branch but this is not done in this case ? Look more like TAP ?

[@dramolchavhan935]

In LAD significant plaque burden us there(between 2 LAD stent ) should we leave it alone or cover with one more stent ?