Case 2 – LAD PCI

Case Presentation

A 90-year-old male presented with angina pectoris and dyspnea on exertion.
Cardiac CTA revealed 50-70% LAD stenosis distal to the stent.
Medical History: Severe aortic stenosis s/p TAVR(CoreValve 31mm) on 9/23/14, CAD (s/p DES to mid and prox LAD on 8/18/14), Lymphoma, and Autoimmune disease (on prednisone).

Coronary angiogram was performed by using JL4/JR4 without any difficulty. It showed 50-60% in mLAD, and multiple discrete lesions in mid RCA.

IVUS of LAD showed MLA of 3.5 mm.² Given the proper engagement of left coronary system with JL4, we used VL 3.5 for PCI and DES (Xience) 3/12 was placed with good result.

Learning Points

JL4/JR4 can also be used in CoreValve cases for selective engagement.
If there is a good catheter engagement with diagnostic JL4 catheter, we could use VL 3.5 guide catheter for left coronary artery intervention.

Model	Burst (ATM)	Diameter (mm)	Balloon Length (mm)
			6	8	12	15	20	25	30
MINI TREK (CTO INDICATED)	1.27	1.2	✓	✓	✓	✓	✓
	1.56	1.5	✓	✓	✓	✓	✓
	2.17	2	✓	✓	✓	✓	✓	✓*	✓*
TREK	2.37	2.25	✓	✓	✓	✓	✓	✓	✓
	2.67	2.5	✓	✓	✓	✓	✓	✓	✓
	2.91	2.75	✓	✓	✓	✓	✓	✓	✓
	3.11	3	✓	✓	✓	✓	✓	✓	✓
	3.5	3.25	✓	✓	✓	✓	✓	✓	✓
	3.7	3.5	✓	✓	✓	✓	✓	✓	✓
	3.94	3.75	✓	✓	✓	✓	✓	✓	✓
	4.32	4	✓	✓	✓	✓	✓	✓	✓
	4.86	4.5			✓	✓
	5.36	5			✓	✓
*Only available as RX, not as OTW. Other sizes available in both versions.
Retrieved on April 07 2022 from Abbott product ordering information. Please look at the company's files for the latest available data on device configurations and avilability in your area.