Case of the Month
|Operators: Dr. Ling-ling CHEUNG, Dr. Chi-kin CHAN|
A 66 year old gentleman, non-smoker, with diabetes, hypertension and hypercholesterolemia presented with unstable angina. He had past history of triple vessel disease with coronary stenting done in another hospital in 1995, the details of which was unknown. Coronary angiogram revealed severe mid LAD in stent restenosis (ISR), severe proximal LCX in stent restenosis and distal to stent another subtotal occlusion, whereas proximal RCA was near totally occluded. The mid LAD lesion was first treated in last session smoothly but subsequent attempts to open LCX ISR failed despite repeated use of high pressure noncompliant balloons. IVUS showed circumferential calcium and under-expansion of previous stent despite it failed to advance distally......