thank you sir ! would it not be better to stent Lima to LAD. that disease at touch down seem to be significant . And Later stenting or POBA to the SVG to Diagonal branch if needed. Just asking for my learning
SPECT stress testing on this patient did not show apical ischemia (only lateral), which made us believe the anastomotic stenosis is not significant. That was actually another reason to believe, as we were progressing through the case, that there must be some graft providing good flow to the LAD. LIMA injection through a 4Fr catheter created contrast streaming and may have exaggerated the angiographic appearance. His angina resolved with treating the SVG-diagonal. Otherwise, we would have considered bringing him back and doing better LIMA engagement from a femoral access (his left radial is used as bypass), followed by iFR/FFR if needed. Definitely do not stent moderate disease without proving hemodynamic significance, especially in such an area of high shear stress and high restenosis risk.
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thank you sir ! would it not be better to stent Lima to LAD. that disease at touch down seem to be significant . And Later stenting or POBA to the SVG to Diagonal branch if needed. Just asking for my learning
SPECT stress testing on this patient did not show apical ischemia (only lateral), which made us believe the anastomotic stenosis is not significant. That was actually another reason to believe, as we were progressing through the case, that there must be some graft providing good flow to the LAD. LIMA injection through a 4Fr catheter created contrast streaming and may have exaggerated the angiographic appearance.
His angina resolved with treating the SVG-diagonal. Otherwise, we would have considered bringing him back and doing better LIMA engagement from a femoral access (his left radial is used as bypass), followed by iFR/FFR if needed. Definitely do not stent moderate disease without proving hemodynamic significance, especially in such an area of high shear stress and high restenosis risk.
Sir plzz make a Video on Baloon/guidewire/stent troubleshooting during PCI🙏
Sir if we improved flow to the native LAD by stenting the SVG-Diag, aren't we risking occlusion of LIMA-LAD due to enhanced competition??
God job
Sir i am from India, please make a video about ppi aicd crtd crtp in detail please sir
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Can I send you a case sir
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Can I send you acase sir ?
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Can I send you acase sir ?
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And I would ask for a tips that may help us for engaging grafts from left and right radial