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Case summary

-55-year-old male
-Hypertension, dyslipidemia
-Oct 2015: NSTEMI: long lesion in the context of myocardial bridging on mid LAD; FFR 0.75 à PCI on middle LAD with Biomatrix 3.5x11 mm, Stentys Xposition S 3.0-3.5x27 and 2.5-3.0x22 mm; postdilatation 3.0 NC 20 atm
-Dec 2016: In-stent occlusion (Stentys); unsuccessful PCI
-Possible Stentys fracture in mid LAD; ipsilateral epicardial collateral from CX
-SYNTAX score: 13.5
-J-CTO score: 2 (long occlusion; redo procedure)

Strategy

ACCESSES:

-Femoral 7F; XB 3.5 catheter, long sheath

APPROACHES:

-Antegrade true-to-true
-Corsair + Fielder FC
-OCT
-Scoring balloon; NC balloon
-Stenting
-Post dilatation with NC balloon
-OCT

Protocol: OptiRAY (Ioversol)

-Concentration: 350 mgl/mL
-Flow rate: 4mL/s
-Volume per injection: 14 ml
-Volume: 340 mL

 

Shooting date : 2017-01-26
Last update : 2021-06-09

OptiRAY® / Guerbet

Optiray® contrast agent is lower osmolar, lower viscosity and nonionic.

Ballon Scarifiant Actif Angiosculpt X / Philips

Cathéter à ballonnet d’abrasion pour Angioplastie coronaire transluminale percutanée (PTCA) enrobé d’un médicament

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From Access to Closure through Treatment:

How to Maximize Outcomes while Minimizing Impact

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DanGER shock trial results and the significance to reduce adverse events

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Can PCI outcomes get any better?

Advancing the standard of care with bioadaptor

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The role of hemodynamic support in cardiogenic shock:

When to escalate and when to de-escalate

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Bifurcation PCI, when finishing with one or two stents is not obvious

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