Video : How to deal with instent CTO due to stent fracture ?

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Cardiology / Coronary / Cto / Case in the box

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DESCRIPTION
Equipment used

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