Apresentao do PowerPoint

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Operators Alexandre C. Zago, MD, PhD José C.
Raudales, MD, PhD
Kissing drug-eluting stent for left main coronary
artery bifurcation and stent for a complex lesion
in saphenous vein graft under distal protection
Lutheran Hospital, Porto Alegre, Brazil
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Introduction

• LL, 77 year-old, male, caucasian
• Risk factors hypertension, dyslipidemia and
  diabetes (non-insulin-dependent)
• Bypass surgery 12 years ago (3 saphenous graft
  and no LIMA graft) only saphenous graft for LAD
  pervious
• LVEF 38 (echocardiography)
• Unstable angina even with the use of optimized
  anti-angina medication

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Bypass Saphenous Graft-LAD
Lutheran Hospital-Brazil
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Bypass Saphenous Graft-LAD
FilterWire EZ System
Libertè 4.0x16mm stent
Lutheran
Hospital-Brazil
Libertè 4.0x16mm stent
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LMCA
Lutheran Hospital-Brazil
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LMCA
Kissing-balloon 2 Mercury 2.5x14mm balloons
Kissing-stent 2 Endeavour 2.75x18mm stents
Lutheran Hospital-Brazil
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LMCA
Final result
Pre-PCI
Lutheran Hospital-Brazil
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LMCA
Final result
Pre-PCI
Lutheran
Hospital-Brazil
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Follow-up 4 months
Lutheran Hospital-Brazil
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Summary

• Kissing-balloon kissing-stent with DESs
  covering the ostium of the LMCA is safe and
  effective for the treatment of the LMCA
  bifurcation with hypothetical lower risk of LMCA
  dissection.
• The use of an extra back-up guiding catheter
  and a hidrofilic 0.014 wire to guide the
  filter-wire have proven to be useful for the
  treatment of severe and eccentric lesions in
  curved segments of saphenous vein graft.