case_images: PMC11766261_01
case_images: Right coronary artery (Left anterior oblique view:LAO).
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case_images: The coronary angiogram revealed multi-vessel coronary artery disease (MVCAD), with the right coronary artery(RCA) revealed as the culprit vessel (Figure 1).
case_images: RCA result post-procedure.
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case_images: The diagnostic procedure was followed by successful PPCI (Figure 2), with the implantation of three stents (5.0/12, 5.0/12 and 4.5/12 mm Everolimus-eluting stents:Synergy, Boston Scientific) in the RCA and optimal angiographic, procedural, and clinical results.
case_images: Left coronary artery (Right anterior oblique caudal (RAO) caudal view).
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case_images: The ostium of left anterior descending artery (LAD) presented a 75% stenotic lesion, with the proximal segment displaying a 90% lesion (Figure 3).
case_images: Left coronary artery:LAD and LCX (LAO caudal). Red arrow and circle:ostium of LAD. Yellow arrow and square:ostium of LCX.
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case_images: The left circumflex artery (LCX) revealed a 75% stenotic lesion of the ostium and tapered disease of its distal segment with areas of ectasic disease, with the ostium of the ramus intermedius (RI/RM) showing a 75% lesion (modified Medina classification 0-1-1-1) (Figure 4, Figure 5, Figure 6, Figure 7, Figure 8, Figure 9 and Figure 10).
case_images: Left coronary artery:RM(LAO caudal). Green arrow and square:ostium of RM.
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case_images: PMC11766261_01_jcm-14-00328-g005.jpg
case_images: jcm-14-00328-f005
case_images: The left circumflex artery (LCX) revealed a 75% stenotic lesion of the ostium and tapered disease of its distal segment with areas of ectasic disease, with the ostium of the ramus intermedius (RI/RM) showing a 75% lesion (modified Medina classification 0-1-1-1) (Figure 4, Figure 5, Figure 6, Figure 7, Figure 8, Figure 9 and Figure 10).
case_images: Left coronary artery (RAO cranial).
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case_images: PMC11766261_01_jcm-14-00328-g006.jpg
case_images: jcm-14-00328-f006
case_images: The left circumflex artery (LCX) revealed a 75% stenotic lesion of the ostium and tapered disease of its distal segment with areas of ectasic disease, with the ostium of the ramus intermedius (RI/RM) showing a 75% lesion (modified Medina classification 0-1-1-1) (Figure 4, Figure 5, Figure 6, Figure 7, Figure 8, Figure 9 and Figure 10).
case_images: Left coronary artery (LAO cranial).
case_images: jcm-14-00328-g007.jpg
case_images: PMC11766261_01_jcm-14-00328-g007.jpg
case_images: jcm-14-00328-f007
case_images: The left circumflex artery (LCX) revealed a 75% stenotic lesion of the ostium and tapered disease of its distal segment with areas of ectasic disease, with the ostium of the ramus intermedius (RI/RM) showing a 75% lesion (modified Medina classification 0-1-1-1) (Figure 4, Figure 5, Figure 6, Figure 7, Figure 8, Figure 9 and Figure 10).
case_images: Preprocedural IVUS LCX. White arrow:axis.Orange circle:vessel area. Blue circle:remaining luminal area.
case_images: jcm-14-00328-g008.jpg
case_images: PMC11766261_01_jcm-14-00328-g008.jpg
case_images: jcm-14-00328-f008
case_images: The left circumflex artery (LCX) revealed a 75% stenotic lesion of the ostium and tapered disease of its distal segment with areas of ectasic disease, with the ostium of the ramus intermedius (RI/RM) showing a 75% lesion (modified Medina classification 0-1-1-1) (Figure 4, Figure 5, Figure 6, Figure 7, Figure 8, Figure 9 and Figure 10).
case_images: Preprocedural IVUS LAD. White arrow:axis. Yellow circle:vessel area. Gray circle:remaining luminal area.
case_images: jcm-14-00328-g009.jpg
case_images: PMC11766261_01_jcm-14-00328-g009.jpg
case_images: jcm-14-00328-f009
case_images: The left circumflex artery (LCX) revealed a 75% stenotic lesion of the ostium and tapered disease of its distal segment with areas of ectasic disease, with the ostium of the ramus intermedius (RI/RM) showing a 75% lesion (modified Medina classification 0-1-1-1) (Figure 4, Figure 5, Figure 6, Figure 7, Figure 8, Figure 9 and Figure 10).
case_images: Preprocedural IVUS RI. White arrow:axis. Yellow circle:vessel area. Blue circle:remaining luminal area.
case_images: jcm-14-00328-g010.jpg
case_images: PMC11766261_01_jcm-14-00328-g010.jpg
case_images: jcm-14-00328-f010
case_images: The left circumflex artery (LCX) revealed a 75% stenotic lesion of the ostium and tapered disease of its distal segment with areas of ectasic disease, with the ostium of the ramus intermedius (RI/RM) showing a 75% lesion (modified Medina classification 0-1-1-1) (Figure 4, Figure 5, Figure 6, Figure 7, Figure 8, Figure 9 and Figure 10).
case_images: In vitro procedure.
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case_images: In vitro procedure:model close-up.
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case_images: In vitro procedureunder X-rays.
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case_images: Step 1.
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case_images: Wiring the three branches of the trifurcation (Floppy guide wires in LAD and RI, Hydrophilic guide wire in LCX) (Figure 14).
case_images: Step 2.
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case_images: jcm-14-00328-f015