We are going to have Drug-coated balloon (DCB) forum in the Philippines with special international guest faculties, one of which is Dr. Antonio Colombo. Audience will comprise of interventional cardiologists in the Philippines. I am going to do a case presentation about the role of DCB in bifurcation disease. My case is about an 85 year old male presenting with complex left main bifurcation disease (Medina 1-1-1) with heavy calcification and left anterior descending (LAD) artery chronic total occlusion (CTO) who underwent percutaneous coronary intervention (PCI). Bailout retrograde approach through the septal collaterals was performed after failed antegrade approach then ultimately performed intracoronary snaring using a home made snare in the left circumflex (LCX) artery. Orbital atherectomy was used as part of lesion preparation. Unfortunately intravascular ultrasound (IVUS) was not available at the cathlab. Lesion preparation assessment was only based on balloon expansion behavior. Final bifurcation treatment was hybrid approach with drug-eluting stent (DES) and DCB. Key issues i like to emphasize in the presentation is the strategic approach and decision making points with regards to favoring hybrid treatment over upfront 2-stent strategy. It will be a 10-minute presentation
We are going to have Drug-coated balloon (DCB) forum in the Philippines with special international guest faculties, one of which is Dr. Antonio Colombo. Audience will comprise of interventional cardiologists in the Philippines. I am going to do a case presentation about the role of DCB in bifurcation disease. My case is about an 85 year old male presenting with complex left main bifurcation disease (Medina 1-1-1) with heavy calcification and left anterior descending (LAD) artery chronic total occlusion (CTO) who underwent percutaneous coronary intervention (PCI). Bailout retrograde approach through the septal collaterals was performed after failed antegrade approach then ultimately performed intracoronary snaring using a home made snare in the left circumflex (LCX) artery. Orbital atherectomy was used as part of lesion preparation. Unfortunately intravascular ultrasound (IVUS) was not available at the cathlab. Lesion preparation assessment was only based on balloon expansion behavior. Final bifurcation treatment was hybrid approach with drug-eluting stent (DES) and DCB. Key issues i like to emphasize in the presentation is the strategic approach and decision making points with regards to favoring hybrid treatment over upfront 2-stent strategy. It will be a 10-minute presentation
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This case study explores a complex cardiac intervention involving an 85-year-old patient with significant coronary artery disease. It outlines a strategic problem regarding the avoidance of upfront two-stent PCI and presents a hybrid drug-coated balloon (DCB) strategy that includes innovative techniques like wire externalization and orbital atherectomy. The decision framework emphasizes the advantages of DCB in scenarios where durable scaffolding is unnecessary, highlighting the importance of...