DEBS-071 | Management of Highly Recurrent LM–LAD–LCx Restenosis Using Imaging-Guided, Stent-Less, and Laser-Based Techniques

The final lesion preparation produced TIMI 3 flow without significant dissection and with acceptable recoil-criteria supporting the use of a DCB strategy.Two DCBs were delivered to the prepared LAD segment, and final angiographic result revealed satisfactory vessel patency and excellent distal flow.The patient had a uncomplicated recovery period and was discharged on dual antiplatelet therapy, strong secondary prevention measures and planned follow up in place.He was brought back to the cathlab for a check angiogram in 3 months from the index procedure and this revealed good positive remodelling with no significant left system disease.This case underscores the feasibility of a stent-free approach using DCBs in the context of complex calcified coronary disease, provided that meticulous lesion preparation with multimodality calcium-modification is performed.It highlights the growing utility of DCBs in highrisk patients with diffuse disease, impaired ventricular function, and physiologic indications for preserving vessel compliance and avoiding additional stent implantation