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