Clinical Case Study
14 December 2020
JOURNAL：Eur Heart J.
Article Link
‘Small bifurcation?’ CT myocardial mass volume measurements change therapeutic strategy in coronary artery disease
Youssef S Abdelwahed, Anne-Sophie Schatz 1 2 3 , Ulf Landmesser
KEYWORDS
recurrent chest pain; post DES-PCI;
A 54-year-old male complaining of recurrent chest pain on exertion (CCS
2) was electively admitted for a second recanalization attempt of a
chronic totally occluded (CTO) first diagonal branch. Two years ago, a
drug-eluting stent (DES) deployed to the proximal LAD jailed the
diagonal ostium leading to its occlusion. Based on the angiographic
analysis, seen by contrast filling through the epicardial retrograde
collateral flow from the distal LAD, the vessel was considered to be of
small calibre (Panel 1A). Because of the perceived
interventional risk, intensified maximum medical treatment was the
therapeutic strategy of choice. However, the patient was still suffering
from recurrent chest pain. To gain...
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