A 7 Fr Terumo¢ç sheath was inserted through the right femoral artery and left coronary artery was engaged with an 7 Fr XB 3.5 guiding catheter. The BMW wire, 0.014-inch 190 cm was inserted into the LAD. OCT was performed in order to check the pathology of ISR, which demonstrated soft atheroma with neointimal hyperplasia ( Movie 3). After balloon dilatation at the mLAD was performed with Tazuna 2.5 x 15 mm balloon, Flextome Cutting Balloon was applied for pre-lesion modification (Figure 1). Post-balloon OCT was revealed balloon dissection at the distal edge of previous stent ( Movie 4, Movie 5). The patient developed severe chest pain with ST elevation and BP drop. We decided to deploy the DES at distal to the previous stent (Figure 2). After successful stenting, Drug-Coated Balloon (SeQuent Please 3.0 x 30 mm) was applied for ISR at pmLAD (Figure 3). Then additional balloon dilatation was done with Tazuna 2.5 x 15 mm balloon. The final OCT and angiogram showed successful results ( Movie 6, Movie 7).
|
Leave a comment