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TCTAP C-023 Optical Coherence Tomography Control of the Results of Mesh-covered MGuard Stenting in Posterior ST-elevation Myocardial Infarction: Immediate and Long-term Results
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 67, NO. 16, SUPPL S, 2016
S101
[INTERVENTIONAL MANAGEMENT] Procedural step. Manual vacuum thromboextraction with quick cat 7F was performed. The fragments of predominantly while thrombus were evacuated. On pre PCI-scan (optical coherence tomography) dissection with white thrombus with significant atherosclerotic stenosis. Implantation of an antiembolic mesh-covered stent Mguard Prime (size 3,5 18,14 atm) was performed for optimization. Post PCI myocardial blush grade: 2. Post PCI scan: full thrombus catch. Control catheterization (at 9months): restenosis with drug-eluting balloon PTCA. Case Summary. We experience a case of very late stent thrombosis after drug-eluting stent implantation. The stent protruding into aorta complicated wire crossing and in this case, we also pay attention to manipulate catheter not to deform stent.
TCTAP C-023 Optical Coherence Tomography Control of the Results of Mesh-covered MGuard Stenting in Posterior ST-elevation Myocardial Infarction: Immediate and Long-term Results Dzhamil Arif Asadov,1 Ilya Alexandrovich Kovalchuk,2 Dmitry Kurtasov,1 Victoria Victorovna Fomenko3 1 Moscow City Center of Interventional Cardioangiology, Russian Federation; 2Moscow City Center, Russian Federation; 3RHMDIL, Russian Federation [CLINICAL INFORMATION] Patient initials or identifier number. I.I.O. Relevant clinical history and physical exam. Male, 61 y.o. No history of heart attack or MI. Heavy smoker (over 30 years) Posterior STEMI 2,5 hours. -
At pre-hospital stage: Heparin4000 U Plagril300 mg Aspirin250 mg Morphine10 mg (for anesthesia) TLT Metalyse 9000 U(1,5 hours after the onset of pain)
Relevant catheterization findings. RCA - TIMIII blood flow MBG before PCI: 4 TTG: 3.
S102
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 67, NO. 16, SUPPL S, 2016
Relevant catheterization findings. Coronary angiogram:LM no significant diseases, ectatic LAD 98% ostial narrowing, proximal and mid segment ectatic LCX and RCA ectatic (picture 01, 02, 03) Case Summary. The stent MGuard is safe and effectively prevents eventual dislocation of thrombus fragments during the stenting of the coronary arteries in ACS patients with signs of intraluminal thrombosis. However, the probability of thrombotic masses dislocation at the stent’s edges persists. We have noted a high incidence of in-stent stenosis and target vessel revascularization.
TCTAP C-024 STEMI with Minimal ST Elevation? Primary PCI! Afzalur Rahman,1 Farhana Ahmed1 National Institute of Cardiovascular Diseases, Bangladesh
1
[CLINICAL INFORMATION] Patient initials or identifier number. MA Relevant clinical history and physical exam. A 58-yr, Hypertensive, male, Japanese nationality attended to our emergency department with h/o intermittent chest pain 10 hour. Initial EKG was normal, subsequent EKG shows minimal ST elevation in aVF, L1 and V2 (Less than 1 mm) Relevant test results prior to catheterization. First EKG normal (Picture 1 a) Subsequent EKG minimal Elevation in aVF, L1 and V2 (Less than1 mm) Picture 1
S101
[INTERVENTIONAL MANAGEMENT] Procedural step. Manual vacuum thromboextraction with quick cat 7F was performed. The fragments of predominantly while thrombus were evacuated. On pre PCI-scan (optical coherence tomography) dissection with white thrombus with significant atherosclerotic stenosis. Implantation of an antiembolic mesh-covered stent Mguard Prime (size 3,5 18,14 atm) was performed for optimization. Post PCI myocardial blush grade: 2. Post PCI scan: full thrombus catch. Control catheterization (at 9months): restenosis with drug-eluting balloon PTCA. Case Summary. We experience a case of very late stent thrombosis after drug-eluting stent implantation. The stent protruding into aorta complicated wire crossing and in this case, we also pay attention to manipulate catheter not to deform stent.
TCTAP C-023 Optical Coherence Tomography Control of the Results of Mesh-covered MGuard Stenting in Posterior ST-elevation Myocardial Infarction: Immediate and Long-term Results Dzhamil Arif Asadov,1 Ilya Alexandrovich Kovalchuk,2 Dmitry Kurtasov,1 Victoria Victorovna Fomenko3 1 Moscow City Center of Interventional Cardioangiology, Russian Federation; 2Moscow City Center, Russian Federation; 3RHMDIL, Russian Federation [CLINICAL INFORMATION] Patient initials or identifier number. I.I.O. Relevant clinical history and physical exam. Male, 61 y.o. No history of heart attack or MI. Heavy smoker (over 30 years) Posterior STEMI 2,5 hours. -
At pre-hospital stage: Heparin4000 U Plagril300 mg Aspirin250 mg Morphine10 mg (for anesthesia) TLT Metalyse 9000 U(1,5 hours after the onset of pain)
Relevant catheterization findings. RCA - TIMIII blood flow MBG before PCI: 4 TTG: 3.
S102
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 67, NO. 16, SUPPL S, 2016
Relevant catheterization findings. Coronary angiogram:LM no significant diseases, ectatic LAD 98% ostial narrowing, proximal and mid segment ectatic LCX and RCA ectatic (picture 01, 02, 03) Case Summary. The stent MGuard is safe and effectively prevents eventual dislocation of thrombus fragments during the stenting of the coronary arteries in ACS patients with signs of intraluminal thrombosis. However, the probability of thrombotic masses dislocation at the stent’s edges persists. We have noted a high incidence of in-stent stenosis and target vessel revascularization.
TCTAP C-024 STEMI with Minimal ST Elevation? Primary PCI! Afzalur Rahman,1 Farhana Ahmed1 National Institute of Cardiovascular Diseases, Bangladesh
1
[CLINICAL INFORMATION] Patient initials or identifier number. MA Relevant clinical history and physical exam. A 58-yr, Hypertensive, male, Japanese nationality attended to our emergency department with h/o intermittent chest pain 10 hour. Initial EKG was normal, subsequent EKG shows minimal ST elevation in aVF, L1 and V2 (Less than 1 mm) Relevant test results prior to catheterization. First EKG normal (Picture 1 a) Subsequent EKG minimal Elevation in aVF, L1 and V2 (Less than1 mm) Picture 1