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Daegu Catholic University Medical Center
Promus Eliment Stent in Complex Lesion Intervention
Promus Eliment Stent in Complex Lesion Intervention
Presenter : Jin Bae LeeOperator : Kee Sik Kim, Jin Bae Lee
Patient profilePatient profile
• 83-year-old female • Unstable chest pain for 2 days • Risk factor
- Hypertension (20 years)- Diabetes (8 Years)
• AMI at 1993 - thrombolytic theraphy
• 83-year-old female • Unstable chest pain for 2 days • Risk factor
- Hypertension (20 years)- Diabetes (8 Years)
• AMI at 1993 - thrombolytic theraphy
• Cardiac markers (Initial) – CK-MB : 0.3 ng/ml– cTn-I : 0.01 ng/ml
• Echocardiography – Akinesia of basal inferior, mid inferior and apical inferior wall
– LVEF : 41%
• Cardiac markers (Initial) – CK-MB : 0.3 ng/ml– cTn-I : 0.01 ng/ml
• Echocardiography – Akinesia of basal inferior, mid inferior and apical inferior wall
– LVEF : 41%
Clinical diagnosis : Unstable anginaClinical diagnosis : Unstable angina
CABG of PCI?CABG of PCI?
• 83-year-old female • Triple vessel disease include CTO of LAD• Diabetes• LV dysfunction
• 83-year-old female • Triple vessel disease include CTO of LAD• Diabetes• LV dysfunction
Concern of medical teamConcern of medical team
• Don’t want open thorax• Minimize cost (minimize stent number)• Don’t want open thorax• Minimize cost (minimize stent number)
Concern of patient and familyConcern of patient and family
Sequent 2.0 X 15mm 20 atmSequent 2.0 X 15mm 20 atm Ikazuchi 2.5 X 15mm 18 atmIkazuchi 2.5 X 15mm 18 atm
LCX PCILCX PCI
Five days later, we tried to CTO of LAD interventionFive days later, we tried to CTO of LAD intervention
LAD stent deploymentLAD stent deployment
Promus Element 2.5 X 28mm 20 atmPromus Element 2.5 X 28mm 20 atm
LAD stent deploymentLAD stent deployment
Promus Element 3.0 X 24mm 18 atmPromus Element 3.0 X 24mm 18 atm
Distal and proximal RCA balloon dilatationDistal and proximal RCA balloon dilatation
Sequent 2.5 X 20mm, 8 atm Sequent 2.5 X 20mm, 8 atm
Distal to mid RCA stentDistal to mid RCA stent
Promus Element 2.5 X 16mm 18 atmPromus Element 2.5 X 16mm 18 atm Promus Element 3.0 X 20mm 18 atmPromus Element 3.0 X 20mm 18 atm
Proximal RCA stentProximal RCA stent
Promus Element 3.5 X 16mm 14 atmPromus Element 3.5 X 16mm 14 atm
SummarySummary
• Long lesion include CTO was treated with Promus Eliment stent without difficulty.
•Promus Eliment provide good radio opacity despite thin strut which provide good landmark for adjuvant balloon and stent overlapping.
• Long lesion include CTO was treated with Promus Eliment stent without difficulty.
•Promus Eliment provide good radio opacity despite thin strut which provide good landmark for adjuvant balloon and stent overlapping.
PROMUS Element Stent was engineered for superior visibility
PROMUS Element Stent was engineered for superior visibility
Platinum Chromium alloy is a higher density material which provides superior visibility on the thinnest strut stentPlatinum Chromium alloy is a higher density material which provides superior visibility on the thinnest strut stent