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-040

Presenter

Pavel Grigor'evich Emelyanov

Authors

Alexey Sozykin1, Emelianov Pavel2, Alexandr Shlykov1, Liudmila Ulyanova2, Natalya Novikova1, Evgeniy Averin1, Aleksey Nikitin1

Affiliation

Central Clinical Hospital of the Russian Academy of Sciences, Russian Federation1, Scientific Clinical Center 2 Petrovsky National Research Center of Surgery NRCS, Russian Federation2,
View Study Report
TCTAP C-040
CORONARY - Chronic Total Occlusion

GPS by OCT: At the Next Crossroad, Turn Left

Alexey Sozykin1, Emelianov Pavel2, Alexandr Shlykov1, Liudmila Ulyanova2, Natalya Novikova1, Evgeniy Averin1, Aleksey Nikitin1

Central Clinical Hospital of the Russian Academy of Sciences, Russian Federation1, Scientific Clinical Center 2 Petrovsky National Research Center of Surgery NRCS, Russian Federation2,

Clinical Information

Patient initials or Identifier Number

A.I.

Relevant Clinical History and Physical Exam

Stable angina. EF - 55%. Hypokinesis of the anterior wall of the left ventricular myocardium. Anterior myocardial infarction 6 years ago. The previous two months is a decrease in exercise tolerance. Exercise test positive. Poor quality of life.

Relevant Test Results Prior to Catheterization

Hematology:RBC - 4,600 10x12 cell/l;HGB - 131,000 g/l; PLT - 220,000 10 in 9 cell/l; MPV - 8,500 cube micron; PCT - 0,190%; PDW - 16,500 %; Lei - 5,300 10x9 cell/l;


Relevant Catheterization Findings

RCA dominant. LAD occlusal, distal part of artery is supplied by collaterals.
MOVIE-0003.wmv

MOVIE-0002.wmv

Interventional Management

Procedural Step

The Place of occlusion of the LAD isn¡¯t visualized in angio. We performed OCT pullback from CX to Left Main. Two millimeters (2mm) early of ostium of first marginal branch was detection occlusal ostium of LAD with significance of endothelisation of ostium. The distal tip of the guidewire was formed using the "double wire bend" technique. LAD recanalization has been successfully completed. PCI DES from Left Main to LAD; final kissing-ballons (3.0x15mm in LAD) and  (3.0x15mm in CX); final POT 5.0x10mm ballon.


Final KAG.wmv

Case Summary

Intravascular imaging (OCT) makes to perform recanalization of CTO more safely and more efficiently. The quality of picture by OCT depends on the length of the occluded area and the presence of good collaterals.