Cases > Index > Case details
Complex angioplasty of double RCA
Interventional cardiologist Mauro De Benedictis, MD
Center Interventional Cardiology Unit - Ospedale Mauriziano Umberto I, Torino - Italy
History 71 yrs old female (156H x 56W) with IIB unstable angina .
Angiography Single vessel disease with multiple stenoses of a double right coronary artery with a common ostium, one branch supplying the right ventricule and the posterior septum and one branch the posterior-lateral wall (figure 1).
Strategy

Right radial approach Guiding catheter: 6F Kimny (Boston Scientific) Wire: BMW x 2 (Guidant) Balloon: Adante 2.0/20 mm e 2.5/20mm (Boston Scientific)

Procedure

After predilatation, two Biodivysio SV 2.5/10 mm stents (Biocompatibles) were implanted at 16 atm in the two stenoses of the first branch with good angiographic result. Then the wire was removed and inserted in the first right ventricular branch, and the stenosis of the second branch dilated. Because of impaired flow in the side branch, a 2.0 mm balloon was inflated at 12 atm with restoration of TIMI 3 flow. Finally, a third Biodivysio SV 2.5/10 mm was implanted in the main branch across the bifurcation at 16 atm, and the jailed wire removed. Uneventful outcome. Discharge at day 1

Eight-months angiographic follow up showed mild restenosis in the three stented segments (figure 3 – lateral view); the patient is symptom-free.
Comments Feasibility of complex procedure in a small woman via radial approach