36th PICASSO Seminar in Nagoyapica-sso.net/pdf/picasso36-cases.pdf · ’17.12.27 RCA#3...
Transcript of 36th PICASSO Seminar in Nagoyapica-sso.net/pdf/picasso36-cases.pdf · ’17.12.27 RCA#3...
Video Live Demonstration
症例集2019.5.11 (sat.)
36th
PICASSO Seminar
in Nagoya
Case No. #1 66 y.o. male
Target Lesion: RCA
Diagnosis: AP (CCS-1)
Prior intervention:
Not done
Coronary Risk Factor:
DM, HL
eGFR : : 86 ml/min/m^2
Final CAG Findings: ’19.3.19LVG: Not doneCAG:(RCA #2 75~90%)
鈴鹿中央総合病院
Co-sponsored by アボットバスキュラージャパン株式会社
Case No. #2 71 y.o. female
Target Lesion: LAD(diffuse & bifurcation)
Diagnosis: AP (CCS-1)
Prior intervention:AMI 2018.7.21 Resolute Onyx 2.25*28 (#13)
Coronary Risk Factor:
DM, HL
eGFR : : 34.9ml/min/m^2
Final CAG Findings: ’19.3.19LVG: Not doneCAG:( #1 50%, #6 75%, #7 75%, #8 75%, D1 75%, D2 90%, #11 25%)
東海中央病院
Co-sponsored by 株式会社フィリップス ジャパン
Case No. #3 50 y.o. male
Target Lesion: RCA (Severe calcified lesion)
Diagnosis: AP (CCS-3)
Prior intervention:
’17.12.27 RCA#3 Rota2.0→NSE3.5
’18.06.13 RCA#3 Rota2.0→DCB4.0 TLR
’18.06.18 LAD#7 Rota2.0→DCB2.5
Final CAG Findings: ’19.04.16LVG: Not doneCAG: LAD #7. 50%, #9. 90%RCA #1.25%, #2. 95%
Kanazawa Medical University Hospital
Co-sponsored by アボットバスキュラージャパン株式会社
Coronary Risk Factor:
HT, HL, CKD on HD
eGFR : 5.4 ml/min/m^2
36th PICASSO Seminar in Nagoya 2019.05.11
Theme
『SYNTAX Ⅱ strategyによるPCI治療戦略をどうとらえるか?』
Title
“ RCA CTOを伴うLMTDの治療に対する戦略 ”
岐阜ハートセンター大久保 宗則
36th PICASSO Seminar in Nagoya 2019.05.11
現病歴:
他院にてPCI歴あり。2019年3月より労作時の胸部症状を自覚。CCTAにてLMT+2VD ( LAD, RCA) を認め診断カテーテル検査施行。
臨床診断: #1 陳旧性心筋梗塞
#2 狭心症
#3 高血圧
36th PICASSO Seminar in Nagoya 2019.05.11
Prior intervention : 2011.12.24 #1ACS BMS
2013.01.29 #7 EES
2015.09.16 #12 EES
Coronary risk factor : HT, past smoking
Blood test: Cre: 0.97, eGFR : 58.8 (categories:G3a)
Lipid profile: LDL-C: 117 mg/dl, HDL-C: 53.6 mg/dl, TG: 104 mg/dl
Cardiac echo: EF=44%,
Wall motion : diffuse mild hypokinesis
Final CAG findings (2019/04/19): mid. RCA 75%
dist. RCA 100%
LMT 90%
prox. LAD 90%
36th PICASSO Seminar in Nagoya 2019.05.11
SYNTAX Score : 30
SYNTAXll Score : CABG or PCI
PCI SYNTAX Scorell : 37.9, PCI 4 year Mortality : 12.8%
CABG SYNTAX Scorell : 38.2, CABG 4 year Mortality : 13.1%
36th PICASSO Seminar in Nagoya 2019.05.11
12.3 mm
29.0 mm
LMT ost.
25-70 HU
LCX lumen:2.5mm
clac.
25-100 HUProx. LAD
61.2°
①
②
③
Perfusion area①81.4%②54.5%③53.1%
Access route
LCIA CSulceration
①
Case No.#5 83 y.o. maleTarget Lesion: LMT-LAD(diffuse calcification& bifurcation)
Diagnosis: AP (CCS-3)
Prior intervention:
’19.2.27 POBA(#5-6) for AMI
’19.2.28 SYNERGY2.5/28 (#2-3)
Coronary Risk Factor:
HTN, DyL, T2DM, COPD, CI
eGFR : : 45.1 ml/min/m^2
Final CAG Findings: ’19.2.27LVG: Not doneCAG:( RCA#2 CTO, LMT 75%, LAD #6 75%, #7 75%, D1os 90% )
施設名 名古屋掖済会病院
Co-sponsored by Boston Scientific Japan co.36th 2019- 5/11
NOT CALIBRATED
Case No EVT#1 61 y.o. Male
Target Lesion: Rt SFA
Diagnosis: PAD (TASCⅡ D lesion)
Prior intervention:’19.04.04 AAO
VIABHN 10*79mm(Lt CIA)
VIABHN 7.0*79mm(Lt EIA Proximal)
VIABHN 7.0*59mm(Lt EIA Distal)
Risk Factor: HT, DL, Current Smoking
eGFR: 85.4 ml/min/m^2
PACSS: 0
Occlusion Length: 283.7mm
Final Angio Findings:’19.04.04
Total occlusion of proximal to distal SFA
Collateral from DFA to POP artery
Nagoya Heart Center
Co-sponsored by boston Scientific Japan, OrbusNeichMedical
NOT CALIBRATED