Middle age man , diabetic, classical angina, enzymes sky high, Angiography done outside Double vessel disease - LCX , RCA
LCX culprit, RCA diffuse disease.
Advice angioplasty to LCX , RCA
RCA- tortuous, diffusely disease
LCX angioplasty done , during RCA PLASTY wire couldn't cross the lesion .. balloon support made the situation critical with dissection.. large & long dissection ..
repeated balloon dilatation still stent was not crossing the mid RCA lesion , multiple dissection planes..
proximal balloon dilatation improved flow in RCA..
Finally decided not to stent the artery , leave it as it is flowing well TIMI II
wire removed..
check shots was showing multiple dissection from proximal to distal , PDA flowing well no dissection..
Again after a break of 3 mins.. re tried ..wire went easily.. multiple balloon dilatation with precautions.. so that artery won't get ruptured..
finally stent crossed mid RCA .. then whole RCA stented with multiple stents..
at last TIMI III flow ..

lesson to learn..Always try for some extra mins before leaving procedure.. u may get sucess..

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