Lots of interesting abstracts and cases were submitted for TCTAP 2022. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP C-139
Successful Bailout From Blow-Out Bleeding From Descending Branch of Left Lateral Circumflex Femoral Artery by Balloon Inflation via Trans-Radial R2P System and Polytetrafluoroethylene-Covered Viabahn Stent Placement via Ipsilateral RIKISHI, a Side-grooved Guiding Sheath, System After Successful Recanalization of Left Main Coronary Artery in a Patient With Post-cardiac Arrest Syndrome Under PCPS Support
By Yuta Kikuchi, Tetsuya Ishikawa, Hideyuki Aoki, Hidehiko Nakamura, Kahoko Mori, Yuta Kimura, Tatsuhiko Ito, Tomoaki Ukaji, Kota Yamada, Yukiko Mizutani, Itaru Hisauchi, Shiro Nakahara, Yuji Itabashi, Sayuki Kobayashi, Isao Taguchi
Presenter
Yuta Kikuchi
Authors
Yuta Kikuchi1, Tetsuya Ishikawa2, Hideyuki Aoki1, Hidehiko Nakamura1, Kahoko Mori1, Yuta Kimura1, Tatsuhiko Ito1, Tomoaki Ukaji1, Kota Yamada1, Yukiko Mizutani1, Itaru Hisauchi1, Shiro Nakahara1, Yuji Itabashi1, Sayuki Kobayashi1, Isao Taguchi1
Affiliation
Dokkyo Medical University, Japan1, Dokkyo Medical University Saitama Medical Center, Japan2,
View Study Report
TCTAP C-139
ENDOVASCULAR - Complications
Successful Bailout From Blow-Out Bleeding From Descending Branch of Left Lateral Circumflex Femoral Artery by Balloon Inflation via Trans-Radial R2P System and Polytetrafluoroethylene-Covered Viabahn Stent Placement via Ipsilateral RIKISHI, a Side-grooved Guiding Sheath, System After Successful Recanalization of Left Main Coronary Artery in a Patient With Post-cardiac Arrest Syndrome Under PCPS Support
Yuta Kikuchi1, Tetsuya Ishikawa2, Hideyuki Aoki1, Hidehiko Nakamura1, Kahoko Mori1, Yuta Kimura1, Tatsuhiko Ito1, Tomoaki Ukaji1, Kota Yamada1, Yukiko Mizutani1, Itaru Hisauchi1, Shiro Nakahara1, Yuji Itabashi1, Sayuki Kobayashi1, Isao Taguchi1
Dokkyo Medical University, Japan1, Dokkyo Medical University Saitama Medical Center, Japan2,
Clinical Information
Patient initials or Identifier Number
M. Y.
Relevant Clinical History and Physical Exam
A 84-year-old male recovered the spontaneous circulation after sudden collapse and bystander cardiopulmonary resuscitation. The first electrocardiogram by paramedics showed ventricular fibrillation. At other hospital, one month before, he hospitalized due to congestive heart failure with low ejection fraction (25%) and Xience stent was placed in proximal left anterior descending artery (LAD) due to old myocardial infarction The conscious level was JCS Ⅲ-300,and endotracheal intubation was done.
Relevant Test Results Prior to Catheterization
After arrival, PCPS via rightcommon femoral artery (CFA) and left CFV was inserted. In addition, 5Fr sheathwas accidentally inserted via descending branch of left lateral circumflexfemoral artery (LLCFA). Xience Skypoint(4x18mm) was placed with the final kissing balloon technique (Figure 1) for severestenosis at distal bifurcation of left main coronary artery (LMCA) (Figure 2) byoverlapping with the previous Xience stent (Figure 3) via left CFA with 7Frsheath.
Relevant Catheterization Findings
The bleedingat 5Fr sheath site of LLCFAcouldnot cease manually (Figure 4). Thus, ballooning (6x40mm) was firstly tried vialeft radial artery using a R2P system (7Fr Glidesheath, 120cm SlenGuide guidingcatheter, and 300cm 0.014inch Cruise wire) (Figure 5) prior to exchanging the7Fr sheath for PCI to 8Fr for IABP. However, the blow-out bleeding recurredafter more than 30 minutes inflation (Figure 6).
Interventional Management
Procedural Step
Thus, concomitant with balloon inflation via R2P system, the 6Fr RIKISHI, a side-grooved guiding sheath, was inserted via left CFA ipsilaterally, and Cruise wire was passed into LLCFA. The values of activated clotting time during the procedure were between179s and 280s. Viabahn stent (6x40mm) could be smoothly deployed via RIKISHI sheath. However, there remained small bleeding (Figure 7). Then, post-dilation using 5x40mm balloon (Figure 8) was undergone, made successful bail-out from blow-out bleeding from LLCFA (Figure 9). Finally, 7Fr sheath for PCI was exchanged to 8Fr sheath forIABP, without removing RIKISHI sheath.
Case Summary
We successful bailed out from blow-out bleeding from descending branch of left lateral circumflex femoral artery by combing the balloon inflation via trans-radial R2P System and the polytetrafluoroethylene-covered Viabahn stent placement via ipsilateral RIKISHI, a side-grooved guiding sheath, system after successful recanalization of left main coronary artery in a patient with post-cardiac arrest syndrome under PCPS support.