Video Live Demonstration

症例集2019.5.11 (sat.)

36th

PICASSO Seminar

in Nagoya

Case No. #1 66 y.o. male

Target Lesion: RCA

Diagnosis: AP (CCS-1)

Prior intervention:

Not done

Coronary Risk Factor:

DM, HL

eGFR : : 86 ml/min/m^2

Final CAG Findings: ’19.3.19LVG: Not doneCAG:(RCA #2 75~90%）

鈴鹿中央総合病院

Co-sponsored by アボットバスキュラージャパン株式会社

Case No. #2 71 y.o. female

Target Lesion: LAD(diffuse & bifurcation)

Diagnosis: AP (CCS-1)

Prior intervention:AMI 2018.7.21 Resolute Onyx 2.25*28 (#13)

Coronary Risk Factor:

DM, HL

eGFR : : 34.9ml/min/m^2

Final CAG Findings: ’19.3.19LVG: Not doneCAG:( #1 50%, #6 75%, #7 75%, #8 75%, D1 75%, D2 90%, #11 25%）

東海中央病院

Co-sponsored by 株式会社フィリップス ジャパン

Case No. #3 50 y.o. male

Target Lesion: RCA (Severe calcified lesion)

Diagnosis: AP (CCS-3)

Prior intervention:

’17.12.27 RCA#3 Rota2.0→NSE3.5

’18.06.13 RCA#3 Rota2.0→DCB4.0 TLR

’18.06.18 LAD#7 Rota2.0→DCB2.5

Final CAG Findings: ’19.04.16LVG: Not doneCAG: LAD #7. 50%, #9. 90%RCA #1.25%, #2. 95%

Kanazawa Medical University Hospital

Co-sponsored by アボットバスキュラージャパン株式会社

Coronary Risk Factor:

HT, HL, CKD on HD

eGFR : 5.4 ml/min/m^2

36th PICASSO Seminar in Nagoya 2019.05.11

Theme

『SYNTAX Ⅱ strategyによるPCI治療戦略をどうとらえるか？』

Title

“ RCA CTOを伴うLMTDの治療に対する戦略 ”

岐阜ハートセンター大久保 宗則

36th PICASSO Seminar in Nagoya 2019.05.11

現病歴:

他院にてPCI歴あり。2019年3月より労作時の胸部症状を自覚。CCTAにてLMT+2VD ( LAD, RCA) を認め診断カテーテル検査施行。

臨床診断： #1 陳旧性心筋梗塞

#2 狭心症

#3 高血圧

36th PICASSO Seminar in Nagoya 2019.05.11

Prior intervention : 2011.12.24 #1ACS BMS

2013.01.29 #7 EES

2015.09.16 #12 EES

Coronary risk factor : HT, past smoking

Blood test: Cre: 0.97, eGFR : 58.8 (categories:G3a)

Lipid profile: LDL-C: 117 mg/dl, HDL-C: 53.6 mg/dl, TG: 104 mg/dl

Cardiac echo: EF=44%,

Wall motion : diffuse mild hypokinesis

Final CAG findings (2019/04/19): mid. RCA 75%

dist. RCA 100%

LMT 90%

prox. LAD 90%

36th PICASSO Seminar in Nagoya 2019.05.11

SYNTAX Score : 30

SYNTAXll Score : CABG or PCI

PCI SYNTAX Scorell : 37.9, PCI 4 year Mortality : 12.8%

CABG SYNTAX Scorell : 38.2, CABG 4 year Mortality : 13.1%

36th PICASSO Seminar in Nagoya 2019.05.11

12.3 mm

29.0 mm

LMT ost.

25-70 HU

LCX lumen:2.5mm

clac.

25-100 HUProx. LAD

61.2°

①

②

③

Perfusion area①81.4%②54.5%③53.1%

Access route

LCIA CSulceration

①

Case No.#5 83 y.o. maleTarget Lesion: LMT-LAD(diffuse calcification& bifurcation)

Diagnosis: AP (CCS-3)

Prior intervention:

’19.2.27 POBA(#5-6) for AMI

’19.2.28 SYNERGY2.5/28 (#2-3)

Coronary Risk Factor:

HTN, DyL, T2DM, COPD, CI

eGFR : : 45.1 ml/min/m^2

Final CAG Findings: ’19.2.27LVG: Not doneCAG:( RCA#2 CTO, LMT 75%, LAD #6 75%, #7 75%, D1os 90% )

施設名 名古屋掖済会病院

Co-sponsored by Boston Scientific Japan co.36th 2019- 5/11

NOT CALIBRATED

Case No EVT#1 61 y.o. Male

Target Lesion: Rt SFA

Diagnosis: PAD (TASCⅡ D lesion)

Prior intervention:’19.04.04 AAO

VIABHN 10*79mm(Lt CIA)

VIABHN 7.0*79mm(Lt EIA Proximal)

VIABHN 7.0*59mm(Lt EIA Distal)

Risk Factor: HT, DL, Current Smoking

eGFR: 85.4 ml/min/m^2

PACSS: 0

Occlusion Length: 283.7mm

Final Angio Findings:’19.04.04

Total occlusion of proximal to distal SFA

Collateral from DFA to POP artery

Nagoya Heart Center

Co-sponsored by boston Scientific Japan, OrbusNeichMedical

NOT CALIBRATED