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2	LM Abrupt Closure Although there are better guides, wires, balloons, stents, antiplatelet and anticoagulant agent, knowledge-that means higher success, lower complication rates than ever before But “PCI has never been safer”-Paul Teirstein said LM Abrupt Closure in Lab is still the most serious and fetal complication
3	Outcomes Once LM Abrupt Closure appearance Death Myocardial Infarction Urgent stents or CABG
4	Classification Abrupt closure: TIMI 0 to II flow Threatened closure: dissection or thrombus with TIMI III flow
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6	oLM & aorta dissection by angiographic catheter- Abrupt closure
7	Reasons Anatomy of coronary arteries: There are vulnerable lesions in LM LM lesion was calcified or eccentric Inadequate technique or equipment Angiography catheter or guiding cathter Guiding wire Balloon or stent or other
8	Risk factors ACS Female gender Elder age Diabetic Pts Poor LV function Chronic renal failure Complex lesions, etc
9	Prevention Review Pt’s history and  coronary anatomy Manipulate  gently and carefully Choose adequate technique and equipment
10	Treatment Hold hemodynamic stable as you can Recanalize  LM and recovery flow as soon as possible Bail-out stent(s) Urgent CABG
11	Case 1
12	Case 2
13	Thank you