Figure 6.1
(a) Cranial view of left anterior descending artery showing long segment of diffuse disease from proximal to mid vessel. (b) White arrows indicate heavily calcified left anterior descending artery. (c) Under-expanded 2.5 mm non-compliant balloon with remaining indentation despite inflation at 22 atm. (d) Rotational atherectomy was attempted with a 1.75 mm burr, but it did not pass through the heavily calcified proximal segment
The initial strategy was to pre-dilate the lesion with a non-compliant balloon and implant a 3.5 × 38 mm drug-eluting stent starting from the ostium of the LAD. A 2.0 mm balloon was however difficult to advance into the lesion. Therefore, a buddy wire was used for support and the balloon successfully passed. However, when inflating with a 2.5 mm non-compliant balloon to high pressure (22 atm), it was clear that the balloon was not fully expanded (Fig. 6.1c).
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