PMC3916001_01
Coronarography of the left coronary artery - significant stenoses of middle segment of the left anterior descending artery (white arrows)
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Massive calcification of all coronary arteries was observed (Figures 1 and 2).
Coronarography of the right coronary artery
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Massive calcification of all coronary arteries was observed (Figures 1 and 2).
Rotational atherectomy of the left anterior descending artery (white arrow - rotablator drill)
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In the next stage of the procedure rotational atherectomy on the whole length of the calcified stenosis was performed by means of a rotablator with a calibre 1.25 mm drill (Figure 3).
A, B. Predilatation of left anterior descending artery
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Subsequently a predilatation was performed with a 2.5/33 mm high-pressure balloon catheter using maximum pressures of 12 atm (Trec NC, Abbott Vascular) (Figures 4A, B).
A, B. Implantation of two stents using a Guideliner catheter (white arrow)
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Because this technique turned out to be ineffective in transporting the stents, a catheter deeply intubating the coronary artery up to the stenosed area was used instead (GuideLiner, Vascular Solutions) (Figures 5A, B).
Coronarography of left coronary artery - final effect of PCI
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The desired result was achieved (Figure 6).