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Clinical Case Study14 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;

ABSTRACT

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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