Procedure:

LCA engaged with 6F EBU 3.5 Guiding Catheter. Then the LCX was wired with 0.014" x 190 CM Run Through NS PTCA Guidewire parked distally in OM4 and LCX-OM4 lesion pre dilated with 2.0 X 15 mm Scientific NC Apex PTCA Balloon at 16 atm for 20 seconds. Then the wire repositioned in OM3 and OM3 ostial lesion attempted to dilate with 2.0 X 15 mm NC balloon couldn't cross. Then a Guidezilla guide extension catheter was used to intubate deeply and the lesion was pre dilated with 1.5 X 15 mm mNC PTCA Balloon at 18 atm for 20 seconds. Then the lesion was again dilated with 2.0 X 15 mm NC PTCA Balloon at 20 atm for 20 seconds. Then a 2.5 X 40 mm CLEAR PAC PACLITAXEL DRUG COATED BALLOON was inflated across the entire LCX-OM3 ostium at 8 atm for 90 seconds. Final Angiogram showed optimal result with TIMI III flow with no residual stenosis or dissection.

Then the wire was removed from LCX and parked in LAD. The LAD lesion was pre dilated with 2.5 X 15 mm NC PTCA Balloon and inflated at 18 atm for 20 seconds. Then IVUS was done using HD catheter. IVUS showed distal vessel reference diameter of 3.0 mm and proximal vessel diameter of 3.75 mm with calcified plaques of focal 270° arc calcification. Then a 3.0 X 33 mm eluting coronary stent was deployed at 12 atm for 20 seconds. Then the stent was post dilated with 3.5 X 15 mm NC PTCA Balloon inflated at 20 atm for 20 seconds. There was a focal under expansion of stent. Hence a 3.75 X 8 mm NC PTCA Balloon was used to post dilate at 20 atm for 20 seconds and proximal stent post dilated with 3.75 X 8 mm NC PTCA Balloon inflated at 20 atm for 20 seconds.