Deficult scenario during p pci. culprit LCX. non Culprit LMS and LAD.

male pt presented with inf STEMI. LVF. ischemic MR. shifted for primary pci. culprit LCX total occlusion and non Culprit LMS and lad with critical stenosis. primary pci to lcx done there was slow reflow so decided to not to do lms, lad during index procedure. shifted to icu on norepinephrine and lasix infusion. improved in a couple of hours. Next day, echo mild MR.
During index admission, we decided to intervene in the lms and lad as staged procedure. ivus pull back showed moderate calcification. Good ostial coverage of lcx stent with few struts hanged in lms.
staged pci to lms lad done. sort of staged crushed of lcx stent. KBI for diagonal. pot, KBI, and repot.
final ivus pull back from lad to lms showed good expension and complete ostial coverage of both vessels.
timi III flow achieved.

[@aslamDr143]

Masha Allah
Excellent Share Sir.
May Allah Almighty bless you with his Rehmat.

[@drimranhanifhashmi5442]

Same to you

[@aymanal_ezair5150]

Nice job