Скачать с ютуб Case 165: Manual of PCI - NSTEMI in an elderly patient в хорошем качестве

Case 165: Manual of PCI - NSTEMI in an elderly patient

An 89-year-old woman presented with NSTEMI and was found to have distal left main disease along with stenoses in the proximal/mid LAD and the left main. Wiring the circumflex was challenging due to angulation but was eventually successful using a Samurai RC wire. The LAD was also wired with a workhorse wire. A Sasuke dual lumen microcatheter was used to advance a guidewire into the first obtuse marginal branch that had a severe ostial stenosis. The OM1 was predilated. Attempts to deliver a 2.5x26 mm Orsiro to the circumflex lesion failed due to angulation, even after using a buddy wire and a guide extension. A Wiggle wire was inserted into the circumflex using the Sasuke microcatheter followed by successful stent delivery and deployment. There remained significant ostial disease in the OM1 but it could not be rewired and the patient did not have any chest pain or ECG changes, hence it was left as is. The LAD and left main were stented with DES jailing the circumflex (provisional stenting) with a nice final result.