| LEFT MAIN | Short LM, Bifurcates, normal. |
|---|---|
| LEFT ANTERIOR DESCENDING ARTERY | Type 3 vessel, proximal LAD – 99% Tubular Stenosis. Mid LAD mild stenosis, distal segments - normal. |
| LEFT CIRCUMFLEX ARTERY |
Non-dominant, LCX proximal shows bifurcation stenosis (Medina 1-1-1) involving OM1 with 95% severity.
After OM1, 50% stenosis, distal - normal.
OM1: 95% ostial stenosis, divides into two branches. |
| RIGHT CORONARY ARTERY |
Dominant, proximal to mid normal, distal 50–60% stenosis.
PDA: Ostial mild stenosis, mid 50% stenosis. PLVB: Normal. |
IMPRESSION: TRIPLE + BRANCH VESSEL DISEASE
LMCA was cannulated with EBU 3.0 6F and LCX wired with 0.014 x 180 cm Runthrough wire and parked distally in OM1. The distal LCX was wired with another Runthrough guidewire. Both vessels were sequentially predilated with 2.0 x 10 mm SC balloon up to 12 atm at lesion segments.
Then OM1 was stented with Eternia 2.5 x 12 mm at 12 atm. Proximal part of OM stent was crushed with 2.75 x 10 mm NC balloon up to 16 atm. First SKD was done with 2.5 x 10 mm NC balloon in LCX and 2.5 x 12 mm stent balloon in OM1 at 14 atm. OM wire removed.
Then the LCX was stented with Eternia 2.75 x 12 mm deployed at 12 atm. The OM1 was rewired through the struts of LCX stent with Runthrough guidewire. The stent struts were expanded with 2.0 x 10 mm SC balloon. Final SKD was done with 2.75 x 10 mm NC balloon in LCX and 2.5 x 10 mm NC in OM1 at 14 atm.
Final check angiogram shows good stent apposition, no residual stenosis, no thrombus or dissection, with TIMI III flow in LCX and OM1.
LMCA was cannulated with EBU 3.0 6F. LAD was wired with 0.014 x Runthrough NS guidewire and parked distally. The lesion was predilated with SC balloon 2.0 x 10 mm @ 12 atm and stented with Eternia 2.75 x 12 mm at 12 atm. The stent was postdilated with NC balloon 2.75 x 10 mm up to 18 atm.
Final check angiogram shows good stent apposition, TIMI III flow, no residual stenosis. A well-expanded, optimally deployed stent with no residual stenosis provides laminar flow in the main vessel, prevents carina or plaque shift, and maintains side branch access and perfusion. This is key for long-term side branch patency and myocardial perfusion.