A patient presented with anterolateral STEMI and cardiogenic shock. Diagnostic angiography showed multivessel coronary artery disease with a culprit occlusion of the second obtuse marginal branch and the distal circumflex. Despite vasopressors and inotropes the patient had worsening hypotension and cardiac arrest. He was emergently intubated and an Impella CP was placed with hemodynamic stabilization. The OM2 and distal circumflex were wired using Sion black guidewires and antegrade flow was restored after predilatation with a 2.5 mm balloon. A 2.5x30 mm DES was placed in the OM2 failing the distal circumflex wire, resulting in occlusion of the distal circumflex. The distal circumflex was rewired with a Sion black wire and a 2.25x15 mm DES was placed using the T and Protrusion (TAP) technique with an excellent final result. The patient’s hemodynamics stabilized.
How to do bifurcation stenting: • 16.2 Provisional bifur...