84-year-old female presented with new onset CCS Class III angina with positive SPECT MPI for multivessel ischemia. A cardiac cath three weeks earlier revealed three-vessel coronary artery disease: 90% proximal RCA, subtotal large proximal LAD/Diagonal bifurcation lesion, 80% small LCx-OM1, SYNTAX score of 21 and LVEF of 55%. Patient had a successful intervention of proximal RCA using Promus Premier DES. The case describes PCI of LAD and D1 bifurcation using dedicated two stent (mini-crush) technique and IVUS for post-stent optimization.
From CCC Live Cases