Lots of interesting abstracts and cases were submitted for TCTAP 2021 Virtual. Below are accepted ones after thoroughly reviewed by our official reviewers. Don’t miss the opportunity to explore your knowledge and interact with authors as well as virtual participants by sharing your opinion!
TCTAP C-047
Presenter
Anatolii Larionov
Authors
Anatolii Larionov1
Affiliation
Clinics of the Samara State Medical University, Russian Federation1,
View Study Report
TCTAP C-047
CORONARY - Chronic Total Occlusion
Retrograde Recanalization of In-stent Chronic Total Occlusion of Left Type Circumflex with the Subsequent Trifurcation Stenting of Left Main
Anatolii Larionov1
Clinics of the Samara State Medical University, Russian Federation1,
Clinical Information
Patient initials or Identifier Number
Patient M., 54 year old
Relevant Clinical History and Physical Exam
Patient M. 54 y.o., male, suffered within 5 years from Angina with mild exertion Class 3.
Relevant Test Results Prior to Catheterization
Echocardioscopy: EF - 50%, Hypokinesia of apico-inferior, apico-lateral and apical segments
Relevant Catheterization Findings
Prolonged left type Cx in-stent occlusion from ostium to the distal bifurcation with ambiguous proximal cap at the left main trifurcation and epicardial and septal collateralsJ-CTO - 4ProgressCTO - 2
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1.wmvInterventional Management
Procedural Step
Patient had prolonged left type ostium Cx in-stent chronic total occlusion with ambiguous proximal cap and unclear distal cap. He had also well developed epicardial collateral from Intermediate to Cx and septal collaterals. Sion blue with Corsair successfully crossed septal loop and achieved the distal cap of occlusion near bifurcation. Tip injection was performed and shown false lumen position of distal occluded stent. Both antegrade and retrograde attempts were performed and channel dilatation allowed retrograde wire to place in guiding catheter. Trapping and externalization were performed. After predilatation 3 DES from Cx to LM were implanted. POT, TAP-stenting of IMA, trifurcation-kissing, post-POT consequently were performed.
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distal cap.wmv tri-ball.wmv fin1.wmvCase Summary
CTOs are the most difficult and unpredictable procedures in coronary interventions and operator have to be ready to deal with all contemporary coronary techniques to achieve procedural success and to show reliable long-term result.