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-020
Calcium Nodule Treated With Rotational Atherectomy and Drug Coated Balloon
By Muhammad Andi Yassiin, Rajinikanth Rajagopal
Presenter
Muhammad Andi Yassiin
Authors
Muhammad Andi Yassiin1, Rajinikanth Rajagopal2
Affiliation
Jakarta Heart Center, Indonesia1, Gleneagles JPMC, Brunei Darussalam2,
View Study Report
TCTAP C-020
CORONARY - Adjunctive Procedures (Thrombectomy, Atherectomy, Special Balloons)
Calcium Nodule Treated With Rotational Atherectomy and Drug Coated Balloon
Muhammad Andi Yassiin1, Rajinikanth Rajagopal2
Jakarta Heart Center, Indonesia1, Gleneagles JPMC, Brunei Darussalam2,
Clinical Information
Patient initials or Identifier Number
LAJ
Relevant Clinical History and Physical Exam
This 72 year old man presented with atypical presentation with jaw pain. In view of his pre Previous CABGx2 (LIMA-LAD, SVG-OM) in 2003, treadmill test was done, with the result of positive treadmill test at moderate workload. Angiography and graft study revealed native triple vessel disease with significant lesion in SVG-OM graft. PCI to SVG-OM was done uneventful, and was staged for PCI to RCA.
Relevant Test Results Prior to Catheterization
Treadmill test: Positive at moderate workload
Relevant Catheterization Findings
RCA - 80% stenosis in mid RCA (heavily calcified). Distal disease in RPDA (ectatic)
RCA Cranial Pre.wmv
RCA LAO Pre.wmv
RCA Cranial Pre.wmv RCA LAO Pre.wmvInterventional Management
Procedural Step
6F JR 4.0, later on exchanged with SAL 1/7F then finally AL 1/7FLesion crossed with a Sion Blue wire with Finecross microcatheter supportExchanged for a RotaWireRotablation performed (2 runs at 160,000 rpm) using 1.5mm burr (difficulty in advancing 1.75 mm burr past proximal bend) in proximal and mid-RCA. Transient bradycardia - improved spontaneously (Isoprenaline connected for back-up but not used)OCT assessment- thick calcium nodule in mid RCA, circumferential calcification with cracks in proximal RCA, sufficient MLAMid RCA pre-dilated with 4.0 mm NC and treated with DCB Agent 4.0x15 mmProximal RCA pre-dilated with 4.0 mm NC and treated with DCB Magic Touch 4.0x20 mm, post-dilated with 4.5 mm NCGood result, acceptable residual stenosisGood final angiographic result
1 Rota 1st run.wmv
2 Rota 2nd run.wmv
3 OCT post Rota.avi
4 RCA Cra post Rota and NC.wmv
5 RCA LAO post Rota and NC.wmv
6 RCA Cra Final.wmv
7 RCA LAO Final.wmv
1 Rota 1st run.wmv 2 Rota 2nd run.wmv 3 OCT post Rota.avi 4 RCA Cra post Rota and NC.wmv 5 RCA LAO post Rota and NC.wmv 6 RCA Cra Final.wmv 7 RCA LAO Final.wmvCase Summary
In view of thick calcified nodule we chose to use DCB as rather than putting a stent. To prepare the lesion we use rotational atherectomy and non-compliance balloon. With good lesion preparation and no significant severe recoil it is acceptable to use DCB to treat the lesion.