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Tackling ostial LAD lesions : A new technique

Posted Jun 23 2010 8:32am

Bifurcation lesions and ostial lesions  continue to  challenge the expertise of   interventional cardiologists.

Variety of techniques have been described. Geo positioning of a ostial lesions ,  exactly on the rim of ostium  is required  . This is very difficult in  many patients  , as stent migration either into side branch or protrusion into the main branch is common. Both reduce  optimal  PCI outcome  .

Here is a innovative  technique   described  first by  Szab0 in 2005 TCT conference .

Highlights of the technique

  • It is a twin guide  wire technique.
  • The Circumflex guide  wire  is threaded over the most proximal strut  of  balloon mounted  LAD stent .
  • The guidewire makes sure the LAD stent move beyond the LAD ostium .
  • Of course some technical limitation is  there, this seems to be a good option at least in some deserving  LAD ostial or LCX ostial lesions

Technical hitch

The balloon and stent is to be manhandled prior to deployment.  We are little awry to do it


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