Post on 15-Aug-2020
K-IMAGING 2019 Cases for LIVE
Case # M/57 IP-0896392
M/57
PMHx.
11 MAR 2016 :
Dx : STEMI
Risk factor : Current smoker. LDL- Cholesterol 106 mg/dL
Thrombolysis with Actylase IV
p-m LAD ABSORB 3.5/28mm (IVUS guided) 3 days later
TTE
Severe hypokinesia of anterior (apex) & inferior(apex) wall
Hypokinesia of anteroseptum (mid) wall
Mild hypokinesia of anterior (mid) & inferoseptum(mid) wall
EF=57%
Index PCI: 2011-03-11
ABSORB 3.5x28 mm
Discharge Medication
Ticagrelor 90㎎ BID Aspirin 100mg
Dilatrend 3.125mg Atorva 20 mg
ABSORB thrombosis: 2011-03-28POBA: NC trek 3.5*15mm, 20atm
Medication
Ticagrelor 90㎎ BID Aspirin 100mg for 1 year
-> Clopidogre 75 mg Aspirin 100mg
Dilatrend 3.125mg Atorva 40 mg
F/U CAG: 2019-05 (3Years 1Month)
Chest pain recurred
Head to Head Comparison for ABSORB Absorption
•Gray-Scale IVUS
•NIR-IVUS
•OCT
Case # M/58, IP-0808422
PMHx. 02/NOV/2012 :
Dx : Stable anginaRisk factor :
FHx of premature CADCurrent smokerLDL- Cholesterol 165 mg/dL
Index PCI: 2012-12-02
Nobori stent 3.0*28mm
Recurrent exertional chest pain F/U CAG : 22 MAY 2019
after 6 and half years
Intermediate p-LAD ISR lesion
•ISR mechanism
•Imaging study
•Physiology study
•What is best procedure
Case # M/69, IP-2156132
Sx : Exertional chest pain
onset ;3 months ago
PMHx ; None
Risk factor;
Ex-smoker : 20 years ago
LDL- Cholesterol 121 mg/dL
CTCA : 10 MAY 2019
Significant (>50%%) stenosis is suspected in mLAD
CAG : not done
c/c: Chest pain for 2hrs
P/I: OPD visit 7days later, smoking (+) DM(+) HTN(+)
Lab: cardiac enzyme (-)
2D Echo: Lat RWMA(+) EF67%
ECG:
Case # M/65, IP-0595937
CTCA 2019-05-20RCA LAD LCX
Case # M/65, IP-0595937
CAG: 2019-05-27
Dx: ACS with MVD
c/c: chest pain, CCS II, 1m ago
P/I: s/p PCI with DES’s 2008
pLAD, dLCX, pRCA, dRCA
smoking ex, DM(+) HTN(+)
Lab: cardiac enzyme (-)
2D Echo: EF65%
ECG:
Case # M/60, IP-0297080
Case # M/60, IP-0297080
CAG w PCI for LAD, LCX, mRCA 2008-07-08
CAG
3V PCI
Case # M/60, IP-0297080
CAG w PCI for dRCA2008-12-02
dRCA PCI
CTCA 2019-05-20
LCX LAD RCA
Dx: s/p 3V PCI with suspicious ISR
c/c: chest pain, CCS III, 3m ago
P/I: s/p PCI with DES’s 2011-01-10
pLAD, dLAD, ramus, mRCA
smoking (-), DM(+) HTN(+)
Lab: cardiac enzyme (-)
2D Echo: EF69%
ECG:
Case # M/80, IP-0708332
Case # M/60, IP-0708332 CAG w PCI for pLAD, dLAD, ramus, mRCA 2011-01-10
CAG
3V PCI
CTCA 2019-04-09
LCX LAD RCA
Dx: s/p 3V PCI with suspicious de novo LCX proggresion