PCi to LAD with two Des 540 2018

Name : 540 2018 N. TH. Abdelaal .

age : 55

operator : Dr khaled Eltamawy . 

                  Dr Ayman Hassan . 

patient background : Scheduled PCI to LAD CTO with DES . 

procedure :

                  premdication :                loading 600 mg clopidogirl .

                  approach :                       Right femral approach

                  catheter :                        Guiding JL guiding  4 & SBS 3.5 guiding catheter . 

                  contrast media  :             250 ml Optray

                 haemostasis :                   manual compression

                 complications :               Nothing

Haemodaynamic data :

                                                           systolic             diastolic              mean

                        Aorta                             120                      60                   80

Operation link  :    https://youtu.be/zgcSrUNj8pQ 

Left Coronary canulated by EBU 4 guiding catheter 6 frensh 

Wire BMW Elite proceeded in the LAD bypass the CTO and settled distally 

Ryujin Balloon  1. 25 x 15 predilate the LAD from Distal to proximal .

Then prediltation with an EUCA balloon 1.5 x 10 with up grading till 15 ATM . 

After dilatation the is TIMI 1 flow with distal very faint filling . 

A stent  Ultimaster  2.2.5 x  28 inflated at 12 ATM but post stenting still TIMI 1 flow and stent appear well apposed . 

Another overlapping stent implanted distal to the 1 st  stent ulimaster 2.2.5 x 8 but flow does not become better .

patient had good general condition without chest pain so descision was taken to give Agrastat and

do another look after 1 month on DUAL antiplateles .

       

Conclusion:         PCI to LAD with two DES  .

Recommendation:    Clopidgrel for 12 month with 150 mg the 1 st  two weeks 

                                   For another session look after 1 month 

  

                                                                                 SIGNATURE

                                                                DR . KHALED ELTAMAWY MD            

                           

                                                  Consulant of cardiology & intervention cardiologyt