MEGAFLEX Patient Cases

Proximal LAD with Diffuse Disease

Case history
Cardiac catheterization was performed on a male diabetic patient with a previous MI, hypertension and hypercholesterolemia. The angiogram seen in Fig.1 and Fig.2 shows the LAD with extensive disease. Not shown was the RCA, a large vessel mildly diseased and not treated during this intervention. The patient also experienced spasms during injection of contrast.

Procedure description
A 6 Fr. Zuma guiding catheter was placed in the LCA and the LAD was wired with 0.014" BMW guide-wire. The two proximal lesions were easily crossed, and a 2.75 mm balloon was placed in the more distal lesion. After two dilations, the Megaflex stent 3.0 x 19 mm was deployed in the distal lesion at 14 atm. Successively another dilation with a 3.0 balloon was performed in the more proximal lesion, and TIMI 3 flow was restored with no evidence of residual thrombus or distal embolic material. The proximal lesion was then stented with a 3.0x17 mm Megaflex stent tandemly to the more distal stent. The result seen in Fig.3 shows an improved vessel diameter and a noticeably improved coronary flow.

Conclusion
The Megaflex coronary stent system of Eurocor tested here provides operators with a safe and easy to navigate device which passes effortlessly through diffusely diseased coronary vasculature. Testing in very angulated 90-degree bends is recommended for this flexible new coronary stent technology.

Case history
A 68-year-old female with recurrent chest pains 3 months after the intervention of the LAD, presented with further progression of diffuse small vessel disease. Angiography identified a total occlusion of the diagonal branch of the LAD (Fig.1) and an occlusion of the PDA of the RCA.

Procedure description
The LAD was wired with two 0.014" BMW guide-wires to protect the vessel, and the occlusion was easily crossed. Following a short dilation with a 2.5 balloon at 12 atm, a Megaflex stent 2.75x15 mm was successfully deployed to reveal the vessel shown in Fig.2 The lesion seen in Fig.3 at the bifurcation of the PDA was then crossed with a 0.014" BMW. An additional wire was also passed down the adjacent branch of the bifurcation. Two balloons were deployed in a kissing technique and then a 2.5x17mm Megaflex coronary stent was passed easily down the diseased branch. Post dilatation reveals the result in Fig.4.

Conclusion
The Megaflex coronary stent system of EuroCOR tested here proves to be a valuable stent for small angulated vessel stenting and navigates the coronary vasculature with ease and flexibility. Additionally, it passes distally through stents to reach difficult and diffusely diseased branches.