By Amin H. Karim MD
A 85 year old dialysis patient who presented with non stemi last week; we stented his occluded RCA with good result and brought him back today for his LAD lesion; looked straightforward but the access to LM proved to be a challenge being on the roof of the sinus in a dilated aging aorta. The lesion itself looked juicy and inviting! 🙂 Iliac was tortuous so we ended up kinking a few catheters till we decided to beat it and go with the longest 7F sheath in the arsenal and a FR 3.5 came to our rescue. The rest was a piece of cake with predilatation and a Resolute Onyx Drug eluting stent 3.0 x 18 stent post dilated with 3.5 mm NC.
According to Dr. Waqas Qureshi, MB guide would be another option in cases of wide aortic roots.
GlobeMedic 