Lots of interesting abstracts and cases were submitted for TCTAP 2023. 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-047
Two Stent Strategy Left Main Percutaneous Coronary Intervention With a Bioresorbable Scaffold in the Circumflex Ostium
By Karlis Grikis, Arnis Laduss, Andrejs Erglis
Presenter
Arnis Laduss
Authors
Karlis Grikis1, Arnis Laduss1, Andrejs Erglis1
Affiliation
Pauls Stradins Clinical University Hospital, Latvia1,
View Study Report
TCTAP C-047
CORONARY - Bifurcation/Left Main Diseases and Intervention
Two Stent Strategy Left Main Percutaneous Coronary Intervention With a Bioresorbable Scaffold in the Circumflex Ostium
Karlis Grikis1, Arnis Laduss1, Andrejs Erglis1
Pauls Stradins Clinical University Hospital, Latvia1,
Clinical Information
Patient initials or Identifier Number
T.S.
Relevant Clinical History and Physical Exam
•Female, 70 y.o•CVD risk factors: Arterial hypertension, Dyslipidemia , Non–insulin-dependent diabetes mellitus•Previous PCI LCX and LAD mid part with DES •Stable angina class II-III•Patient complaints of shortness of breath and discomfort in chest on physical exertion, symptoms persist on optimal anti-anginal therapy•Echocardiogram: Mild left atria dilatation, preserved ejection fraction (EF 55%), Mitral Valve regurgitation I-II
Relevant Test Results Prior to Catheterization
Lab tests:RBC: 5.11 x1012 HGB: 131 g/l PLT: 265 x 109 Creatinine: 79 umol/l; GFR: 66 ml/min/1.73 LDL: 0.73 mmol/l Medical therapy: T. Clopidogrel/Aspirin 75/100 mg x 1 p/oT. Olmesartan/Amlodipini/ Hydrocholthyazidi 40/10/12.5 mg x 1 p/oT. Nebivalol 5 mg x 1 p/o
T. Ranolazin 500 mg x 2 p/oCaps. Rosuvastatin/Ezetimib 20/10 mg x 1 p/o
T. Ranolazin 500 mg x 2 p/oCaps. Rosuvastatin/Ezetimib 20/10 mg x 1 p/o
Relevant Catheterization Findings
Coronary angiography was performed - where severe stenosis ostium or LCX & LM-LAD was found. IVUS LCX and LM-LAD was performed.
Interventional Management
Procedural Step
Femoral approach - 7F EBU 3.75 guide catheter. Lesion assessment was performed on the main and side branches by angiography in two opposite projections and with intravascular ultrasound. Modification of the atherosclerotic plaque was then performed with a cutting balloon - 3.25 mm x 15 in LCX and 3.5x15 LM-LAD. Mini-crush technique was chosen. Left main-LAD Synergy Megatron 4.0 x 16 was implanted, strat opening with 2.50 x 12 mm compliant ballon -> LCX - Magmaris 3.5 x 15 & post dialated with non-compliant 3.5x15. Kissing ballon 3.5x12 & 3.25 x 12 followed by POT - 5.0 x 8 Final result was confirmed by IVUS & OCT.
Case Summary
The use of a hybrid 2 stent/scaffold strategy with DES in the main branch and BVS in the side branch in selected patients with LM true bifurcation disease was technically possible.
The idea of “leaving nothing behind” after PCI is an intriguing concept for the treatment of bifurcation lesions.
Radial strength is main consern using BVS in side branch ostium.
The idea of “leaving nothing behind” after PCI is an intriguing concept for the treatment of bifurcation lesions.
Radial strength is main consern using BVS in side branch ostium.