DKC2 stenting - “Double”, double kissing crushing stenting to LM-LCx & LAD-1st diag
#CardioTwitterCase originally published on Twitter
A step-by-step simultaneous double kissing crushing stenting for a LM-LCX-LAD & 1st Diagonal branch double bifurcation PCI.
This case was originally published on Twitter by @omendiz
Case description
The relevance of following and step-by-step procedure in a complex PCI for a high surgical risk patient after a CABG failure.
We present the case of a 73-year-old male with previous complicated CABG, all graft occluded, a complex LM-LCx, and LAD-Diagonal heavily calcified bifurcation lesions.
We used a 7Fr femoral access with 3 conventional .014” guidewires. A “high” pressure cutting balloon predilatation was performed.
LCx stenting, then crushing and kissing followed by the same sequence for 1st diagonal branch to proceed with LM-LAD stenting and final kissing for each bifurcation and POT for LM were done.
Excellent angiographic (showed in the video) and IVUS (unfortunately, due to a technical issue, we don't have access to these videos) results were achieved. Patient was discharged overnight under DPT.
Videos
POT was performed into the LM with a 4.5 short balloon
Final remarks
In conclusion, a double simultaneous DKC stenting was useful to solve these two bifurcation lesions.
Original tweet and Twitter discussion
How would you treat this 73yo Previous CABG, Severa RCA and Severe distal LM with severe calcified LCx ostium and severe ostial 1rst big Diag ?? (Non of the grafts are patent) @jedicath@mirvatalasnag@djc795@Hragy@ajaykirtane@mmamas1973@evandrofilhobr@torresvierapic.twitter.com/gvjycikpIX
— Oscar Mendiz (@omendiz) February 18, 2022
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