新能吉艾諾莉茉斯冠狀動脈塗藥支架系統治療效果如何？-心臟血管專科

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Indication :known CAD Pre-Cath Diagnosis :Chronic CAD Post-Cath Diagnosis :3VD-CAD, LM-CAD Intervention :Yes Complication:No 因病情需求會診外科, 會診外科後病患拒絕開刀 Stent :YES, DES Procedure Time : ( Start 20:22 Close 21:59 Mins 97 ) Contrast：Ominipaque： 195 ml Vascular Access :Artery, Trans-radial ( R’t ) Intervention Methods :POBA, Stent Additional Procedure :IVUS Hemodynamic: pre-procedure: BP 115/67, HR 85 post-procedure: BP 114/75, HR 80 Coronary Angiography: - Dominant(R’t) - LM -mid LM 80％ stenosis - LAD -mid LAD 50％ diffuse stenosis, mid LAD myocardial bridge ostial major DB 60％ stenosis - LCX -OM 80％ stenosis - RCA -dominant, mid to distal RCA stent no ISR PDA 80％ stenosis - Ramus -nil - Collateral -nil - STNTAX score-n/a Others(Selective Angiography): nil Intervention Procedure: 1.LMCA was engaged with EBU 3.5 7F guiding catheter 2.Runthrough wire was advanced, successfully crossing the lesion to distal LAD 3.Sion wire was advanced to OM 4.pre-dilatation with 3.0x15 mm NC Raiden with 16 atm 5.recoil ＞40％ noted 6.IVUS from LAD to LM showed fibroatheroma with calcification around 90 degree, with RVD of mid LAD 3.5-4.0mm, proximal LAD 4.0-4.5mm, LM 4.5-5.0mm 7.stenting at mid LM to mid LAD with 3.5x48 mm Synergy DES with 8-12 atm 8.POT with 4.0x12 mm NC Emerge with 12-16 atm 9.IVUS from LAD to LM showed underexpansion and malapposition of stent at proximal edge 10.post-dilatation of stent with 3.5x20 mm NC Raiden with 8-26 atm 11.POT with 4.5x8 mm NC Emerge with 12-16 atm 12.IVUS from LAD to LM showed well expansion but malapposition of stent at proximal edge 13.POT with 4.5x8 mm NC Raiden with 12-20 atm 14.IVUS from LCx to LM showed well expansion and apposition of stent, fibroatheroma at mid LCx 15.optimal angiographic result Recommendation: 1.keep dual antiplatelet 2.risk factor management ICD10: 4A023N7-Measurement of Cardiac Sampling and Pressure, Left Heart, Percutaneous Approach 0271346-Dilation of Coronary Artery, Two Sites, Bifurcation, with Drug-eluting Intraluminal Device, Percutaneous Approach 02713T6-Dilation of Coronary Artery, Two Sites, Bifurcation, with Radioactive Intraluminal Device, Percutaneous Approach 02713D6-Dilation of Coronary Artery, Two Sites, Bifurcation, with Intraluminal Device, Percutaneous Approach 植入物 名稱：新能吉艾諾莉茉斯冠狀動脈塗藥支架系統(引進型號限規格檔範圍) 廠牌：荷商波士頓科技有限公司台灣分公司 型號：H7493926248350 48x3.50mm 出廠批號：29975927 效期：2024-08-10 。
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