Lots of interesting abstracts and cases were submitted for TCTAP 2025. 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-038

Rotational Atherectomy After Recanalization of Chronic Total Occlusion of the Right Coronary Artery

By Alexandr Shlykov, Alexey Sozykin, Emelyanov Pavel, Lyudmila Ulyanova, Chingis Delikov, Nataliya Novikova, Igor Lozovskii

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Presenter

Lyudmila Ulyanova

Authors

Alexandr Shlykov¹, Alexey Sozykin¹, Emelyanov Pavel¹, Lyudmila Ulyanova¹, Chingis Delikov¹, Nataliya Novikova¹, Igor Lozovskii¹

Affiliation

Petrovsky National Research Center of Surgery, Russian Federation¹,

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TCTAP C-038

Coronary - Adjunctive Procedures (Thrombectomy, Atherectomy, Special Balloons)

Rotational Atherectomy After Recanalization of Chronic Total Occlusion of the Right Coronary Artery

Alexandr Shlykov¹, Alexey Sozykin¹, Emelyanov Pavel¹, Lyudmila Ulyanova¹, Chingis Delikov¹, Nataliya Novikova¹, Igor Lozovskii¹

Petrovsky National Research Center of Surgery, Russian Federation¹,

Clinical Information

Patient initials or Identifier Number

Relevant Clinical History and Physical Exam

Male 62 years old. M iyocardial infarction 1994. Angina pectoris 2012 ye. Hypertension. Diabetes mellitus.

Coronary stenting of the anterior descending artery 2016 ye. In 2024 ye., after suffering from acute respiratory viral infection, he noted a deterioration in exercise tolerance due to shortness of breath.

The stress test is not informative (severe shortness of breath).

Relevant Test Results Prior to Catheterization

Relevant Catheterization Findings

Chronic occlusion of the right coronary artery

Interventional Management

Procedural Step

A guidecatheter is installed at the ostium of the RCA. Recanalization of the RCA was performed using coronary guidewire of varying stiffness using a microcatheter.Using balloon catheters 1.5x20 mm, 2.5-15 mm NC, 3.0x15 mm NC, predilation was performed in the middle segment of the RCA with a pressure of up to 30 atm. Full deployment of the balloon catheters was not noted.A decision was made to perform rotational atherectomy in the middle segment of the RCA.Transfemoral approach was performed. An 8F guiding catheter is installed at the ostium of the RCA.The RotaWire coronary guidewire is passed beyond the site of stenosis into the distal segment of the RCA. Rotational atherectomy was performed using 1.5 mm bur and 2.25 mm bur at speeds of up to 200 thousand revolutions per minute.A 3.5x8mm NC balloon catheter was used to predilate the site of stenosis in the middle segment of the RCA, with a pressure of 25 atm.Implantation of DES 2.75-44 mm, 3.5-40 mm, 4.0-24 mm was performed in the distal, middle andproximal segments of the RCA, pressure 16, 16 and 16 atm.Implantation of DES 2.75-44 mm, 3.5-40 mm, 4.0-24 mm was performed in the distal, middle andproximal segments of the RCA, pressure 16, 16 and 16 atm.Good final result.

Case Summary

A device for performing rotational atherectomy is necessary to perform complex coronary interventions.The use of rotational atherectomy gives better long-term results in contrast to balloondilatation. Consecutive use of borers of different diameters allows achievingthe best effect of rotational atherectomy.

E-Case

TCTAP C-038