Ostial Circumflex Dissection Caused by Off-Track OCT Catheter

A 53-year-old man was planned for staged PCI to the left circumflex artery (LCX). He had history of primary PCI at the proximal left anterior descending (LAD) 6 months earlier. Following coronary angiogram, it was decided to perform an initial optical coherence tomography (OCT) evaluation. However,...

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Bibliographic Details
Published in:The Journal of invasive cardiology 2022-11, Vol.34 (11), p.E822
Main Authors: Yahya, Achmad Fauzi, Saboe, Aninka
Format: Article
Language:English
Subjects:
Catheters
Coronary Artery Disease
Humans
Male
Middle Aged
Percutaneous Coronary Intervention - methods
Tomography, Optical Coherence - methods
Online Access:Get full text
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Summary:A 53-year-old man was planned for staged PCI to the left circumflex artery (LCX). He had history of primary PCI at the proximal left anterior descending (LAD) 6 months earlier. Following coronary angiogram, it was decided to perform an initial optical coherence tomography (OCT) evaluation. However, during delivery to the LAD, the OCT catheter was railed-off from the guidewire and knocked to the ostial LCX. After guide-catheter repositioning and double-kissing culotte stenting at the left main bifurcation, the patient was finally stabilized. The purpose of these images is to make the readers aware of the genuine and serious risk of a "railed off" OCT catheter, especially while delivering the catheter at a bifurcation with an eccentric lesion. Meticulous OCT catheter delivery and improvement of the OCT catheter configuration may be considered to avoid this complication.
ISSN:1557-2501
1557-2501
DOI:10.25270/jic/22.00084