Challenging Interventional Case Presented at TCT 2013

SAN FRANCISCO, CA. OrbusNeich today announced the presentation of a case in which the company’s Scoreflex coronary dilatation catheter was used to pre-dilate the right posterior lateral artery (side branch), enabling the wiring of the large right posterior descending artery (main branch) for provisional stenting of a chronic total occlusion (CTO) at a bifurcation. This challenging interventional case was presented by Karsten Veien, M.D., of Odense University Hospital, Denmark, at TCT 2013.

The patient was a 58-year-old male with unstable angina and a history of dyslipidemia and hypertension who had previously received a drug eluting stent to treat a stenosis in the left anterior descending artery (LAD). The angiogram revealed a CTO on segment 3 of the right coronary artery and no stenosis of the left coronary artery.

“A CTO at a bifurcation lesion is particularly challenging to wire,” said Dr. Veien. “In this case, we could not wire the main branch and determined that we would wire the side branch instead. Scoreflex was an ideal candidate for this type of lesion preparation because it enabled us to control the plaque fracture. Scoreflex was able to crack the plaque at the bifurcation and ostium of the right posterior descending artery, which then allowed us to wire the main branch to perform bifurcation stenting.”

The investigators used a femoral approach with an 8 French JR4 guiding catheter. The wiring of the right posterior descending artery with Fielder XT, Ultimate 3 or Pilot 50 was impossible. Therefore, the right posterior descending artery was wired with an Ultimate 3, and the bifurcation was pre-dilated with the Scoreflex. Then, the right posterior descending artery was wired with Pilot 200, and the bifurcation was treated with provisional T-stenting and small protrusion technique.

 Source: OrbusNeich