Overview
Dr. Rajesh Sachdeva and Dr. Gautam Kumar used Scoreflex NC Scoring PTCA balloon catheter to successfully treat complex plaque in a patient with progressive exertional angina.
Dr. Rajesh Sachdeva and Dr. Gautam Kumar used Scoreflex NC Scoring PTCA balloon catheter to successfully treat complex plaque in a patient with progressive exertional angina.
A 68-year-old man presented with progressive exertional angina which is now Canadian Cardiovascular Society (CCS) Class 3 severity. He had multiple cardiovascular risk factors including diabetes mellitus, hypertension and hyperlipidemia and had coronary artery bypass surgery 4 years ago with LIMA-LAD, SVG-OM and SVG-RPDA. He had recurrent angina 2 years ago after bypass surgery and a coronary angiography at that time revealed atretic LIMA. At the same time, the distal LAD had an 80% stenosis and non-ischemic iFR (0.91) and FFR (0.81). Medical management was optimized. At that time, he was able to achieve 4.6 MET on the treadmill with his right knee pain limiting exercise.
The proximal portion of the distal LAD was predilated with a 2.5 x 20 mm Scoreflex NC catheter at 12 atm for 20 seconds and then a 2.0 x 15 mm Scoreflex NC catheter was advanced into the more distal portion and inflated at 10 atm for 20 seconds (Figures 3 and 4). Although there was no difficulty in advancing the Scoreflex NC balloon into the distal vessel, the stent was unable to be advanced and an adjunctive 5 Fr GuideLiner® catheter had to be used. A 2.25 x 38 mm drug-eluting stent was then deployed in the distal portion of the distal LAD and then overlapped this in the more proximal portion with a 2.75 x 15 mm drug eluting stent (Figures 5 and 6). These stents were then post-dilated with 2.5 x 35 mm and 2.75 x 12 mm balloons at 18 atm. Excellent final angiographic results were obtained (Figures 7 and 8).
During a clinical follow-up at two years, the patient did not have any anginal symptoms exertion and has increased his ability to walk further following knee surgery.
Scoreflex® NC Scoring Balloon
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