Specials: Rotablation Through LM In-Stent Restenosis

Abstract

An 89-year-old man with a past history of hypertension, hyperlipidemia, and chronic kidney disease presented with recurrent episodes of unstable angina and heart failure. He had prior CAD with triple vessel disease. He had declined CABF and subsequently had PCI to the RCA, left main, LAD, and LCX. One year ago, he had Coulotte stenting of the left main, LAD, and LCX, with everolimus-eluting stents. Four months after that, he had presented with an acute coronary syndrome and angiography showed severe restenosis of the ostial LAD and LCX. The operator at that time opted to treat with balloon angioplasty and drug (paclitaxel)-coated balloon therapy. He represented with multiple admissions for acute syndromes and heart failure (six times over a 4-month period). He had previously preferred medical therapy but due to frequency of events, finally decided for high-risk repeat coronary angiography and possible PCI.