JACC

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 . Presentation

Presenter

Anatolii Larionov

Authors

Anatolii Larionov1

Affiliation

Federal Cardiovascular Center Astrakhan, 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

Federal Cardiovascular Center Astrakhan, 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. Postinfarction Cardiosclerosis - Acute Miocardial Infarction 5 years agoArterial HypertensionDiabetes MellitusUnsuccessful attempts of Cx CTO recanalizations

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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Interventional 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.
distal cap.wmv
tri-ball.wmv
fin1.wmv

Case 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.

Leave Comments

TCTAP 2021 Virtual Apr 12, 2021
Very impressive! Thanks for sharing this study report.