Lots of interesting abstracts and cases were submitted for TCTAP 2024. 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-133
What to Do If the Balloon Catheter Jams During Postdilatation?
By Liudmila Ulyanova, Alexey Sozykin, Alexandr Shlykov, Emelianov Pavel, Natalya Novikova, Diana Izimarieva
Presenter
Liudmila Ulyanova
Authors
Liudmila Ulyanova1, Alexey Sozykin2, Alexandr Shlykov3, Emelianov Pavel4, Natalya Novikova2, Diana Izimarieva2
Affiliation
Scientific Clinical Center 2 Petrovsky National Research Center of Surgery, Russian Federation1, Central Clinical Hospital of the Russian Academy of Sciences, Russian Federation2, Petrovsky National Research Centre of Surgery, Russian Federation3, Scientific Clinical Center 2 Petrovsky National Research Center of Surgery NRCS, Russian Federation4,
View Study Report
TCTAP C-133
Coronary - Complication Management
What to Do If the Balloon Catheter Jams During Postdilatation?
Liudmila Ulyanova1, Alexey Sozykin2, Alexandr Shlykov3, Emelianov Pavel4, Natalya Novikova2, Diana Izimarieva2
Scientific Clinical Center 2 Petrovsky National Research Center of Surgery, Russian Federation1, Central Clinical Hospital of the Russian Academy of Sciences, Russian Federation2, Petrovsky National Research Centre of Surgery, Russian Federation3, Scientific Clinical Center 2 Petrovsky National Research Center of Surgery NRCS, Russian Federation4,
Clinical Information
Patient initials or Identifier Number
Relevant Clinical History and Physical Exam
Since January 2023, the patient began to experience anginal pain, radiating to the left arm during physical activity, which resolved after taking nitroglycerin. Due to the progressive deterioration of health and the ineffectiveness of the therapy prescribed at the outpatient stage, the patient was referred for coronary angiography.
Relevant Test Results Prior to Catheterization
Clinical bloodtest: RBC – 4,4 10in 12 tbsp. / l; HGB - 135 g / l; MCV – 91,3 cubic meters; PLT - 260 10 in 9 st. / l;MPV – 8.7 cubic meters; Leukocytes – 6.7 10 in 9 tbsp. / l; Segmentedneutrophils,% - 73.9%; Lymphocytes – 15,9%; Monocytes - 8.5%; Eosinophils - 0.8%;Basophils - 0.8%; Erythrocyte sedimentation rate - 28 mm / h;
Relevant Catheterization Findings
Type of coronary blood supply: left.LM: has uneven contours.LAD: has uneven contours along its entire length.Cx: 70% stenotic at the mouth, 99% stenotic in the distal segment.RCA: diffusely changed, 90% stenotic in the proximal segment.
Interventional Management
Procedural Step
A guiding catheter was placed in the ostium of the LM. A guidewire was inserted through the stenosed area into the distal Cx bed. The second guidewire was inserted into the distal LAD bed. A 3.0*28 mm DES was implanted into the distal segment of the Cx. A 3.5*34 mm DES was implanted into the Cx with transition to the LM. POT was performed using a 5.0x10mm balloon catheter. During dilatation of the balloon catheter, the balloon catheter became jammed. Numerous attempts to deflate the balloon catheter were unsuccessful. The guide catheter with balloon catheter and guidewires were removed as a complex. The guiding catheter was re-installed in the ostium of the LM. The guidewire was passed into the distal Cx bed. The second guidewire was re-passed through the stent cell into the distal segment of the LAD. 3.5x15 mm and 3.5x15 mm balloon catheters were used to postdilate the stented sections of the LM, LAD, and Cx by "kissing balloons" method. The DES 3.5*38 mm was implanted into the proximal segment of the LAD with transition to the LM. POT was performed using a 5.0x10mm balloon catheter. The guidewire was re-passed through the stent cell into the distal segment of the Cx. 3.5x15 mm and 3.5x15 mm balloon catheters were used to postdilate the stented sections of the LM, LAD, and Cx by "kissing balloons" method. POT was performed using a 5.0x10mm balloon catheter. The control angiography showed the blood flow along the TIMI III arteries. The operation was completed.
Case Summary
Balloon catheter jamming during coronary stenting is quite rare, but it is necessary to know the treatment options for this complication. Knowledge of methods for treating complications helps the operator select the most appropriate treatment method and achieve optimal stenting results.