Imaging Guided PCI of Calcified LM Bifurcation and Additional Vessels with Impella Assistance

Case and Plan:
89-year-old male with known CAD, MI and remote PCI’s, now presented with CCS Class III angina and a positive SPECT MPI for multivessel ischemia and TID. A Cardiac Cath on July 9, 2024 revealed calcific 2V and LM CAD: 80% distal LM, 95% mid LAD, 90% annulated proximal LCx, 95% LCx-OM1 and OM2 ISR bifurcation with SYNTAX Score of 39 and EF 45%. After Heart Team discussion, high-risk protected PCI is recommended. Patient is now planned for imaging guided PCI of calcified LM bifurcation and additional vessels with Impella assistance.

[@draksingh8034]

Thank you for your teaching . Your teaching of guidewire design really helps in rewiring the stented artery.

[@areenal-taie6836]

Thank you

[@sachakepreotis3514]

Thank you for sharing. The final cranial angio looks like a prox stent edge dissection in the left main.

[@wilzboyz]

Great case but why would you ever perform a stress test on an 89M w class 3 angina? Waste of time and money.