Case 85: PCI Manual - Ostial left main/LAD bifurcation stenting

A patient was referred for PCI of unprotected ostial left main and ostial LAD coronary artery lesions. He had normal ejection fraction and was pretreated with ticagrelor. Using femoral access the left main was engaged with an 8 French EBU guide catheter that was intermittently disengaged to prevent dampening. Given no significant disease in the proximal circumflex, a provisional stenting strategy (stent from left main into the LAD jailing the circumflex) was selected. IVUS was performed showed moderate calcification. A non-flow limiting dissection occurred after predilation with an Angiosculpt balloon. A stent was placed from the left main into the LAD and was postdilated at the left main ostium with an Ostial Flash balloon. Post stenting FFR in the LAD was 0.74 with an additional step-up in the mid LAD that was treated with implantation of another stent and a nice final result.