MagicTouch Sirolimus Coated Balloon Treatment in LAD with positive remodeling - Concept Medical

MagicTouch Sirolimus Coated Balloon Treatment in LAD with positive remodeling

A 78-year old man with previous mitral valve repair and CABG (saphenous vein graft to LAD) in 2013 presented with crescendo anginal symptoms. Stress myocardial perfusion scan demonstrated inducible ischemia in the anterior wall of the left ventricle. The coronary angiogram demonstrated a patent vein graft to LAD but had tight insertional stenosis (Figure 1).

 

There was no other significant stenosis elsewhere and he was listed for percutaneous intervention. However, we noted that there was an ecstatic segment in SVG before the stenosis and the caliber of LAD was 2.5 – 2.75 mm. Since there was a big size mismatch, we felt stenting would be challenging as we would not be able to oppose the stent completely in the ectatic segment, hence risking the stent thrombosis. In addition, placing a stent would preclude opening the native LAD if the graft were to fail in the future. So, we opted to treat it with a drug-coated balloon. After a successful pre dilatation with non-compliant and scoring balloons (Figure 2, and Figure 3), we used a 2.5 x 15 mm Sirolimus coated balloon (MagicTouch) to achieve a good result (Figure 4).

Figure 2

CASE Figure 3

 

Case Figure 4

 

The patient underwent check angiogram at 18-months for chest pain, it demonstrated patent vein graft, but more importantly, the treatment segment had no recoil and demonstrated positive remodeling (Figure 5).

Case Figure 5

Case Performed by : Dr. Sandeep Basavarajaiah (Consultant Cardiologist) 

Heartlands Hospital University, United Kingdom  

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