Key result
Prolonged IVUS catheter use during stumpless CTO PCI triggers diffuse coronary artery thrombosis.
Why the study?
PCI of stumpless CTO lesions with a side branch stemming from the occlusion has a significantly lower success rate and the safety of IVUS-guided wiring has not been sufficiently elucidated.
Case Report (n=1)
Prolonged IVUS catheter dwell may precipitate thrombosis in stumpless CTO PCI; leaves open optimal duration and antithrombotic protocols.
Percutaneous coronary intervention (PCI) of stumpless chronic total occlusion (CTO) lesions with a side branch stemming from the occlusion have a significantly lower treatment success rate because physicians cannot identify an accurate entry point with only conventional angiographic images. An intravascular ultrasonography (IVUS)-guided wiring technique might be useful for the penetration of stumpless CTO. We recently experienced thrombotic occlusion during an IVUS-guided stumpless CTO procedure. The cause of the thrombosis is not completely understood; the thrombosis may have been associated with the long use of the IVUS catheter. Special precautions should be taken to prevent thrombus in such cases.
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Lee et al. (2014) conducted a case report in Stumpless chronic total occlusion of coronary artery (n=1). Intravascular ultrasonography (IVUS)-guided wiring technique was evaluated on Thrombotic occlusion complication. Prolonged use of an intravascular ultrasonography catheter during an IVUS-guided stumpless chronic total occlusion percutaneous coronary intervention resulted in diffuse coronary artery thrombosis.
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