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Ostial Circumflex Dissection Caused by Off-Track OCT Catheter
Achmad Fauzi Yahya1, Aninka Saboe
1Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung, Jawa Barat, Indonesia. a.fauzi.yahya@unpad.ac.id.
The Journal of Invasive Cardiology
|November 1, 2022
Summary
A serious risk of optical coherence tomography (OCT) catheter dislodgement occurred during a complex stenting procedure. Careful catheter handling is crucial to prevent this complication, especially at arterial bifurcations.
Area of Science:
- Interventional Cardiology
- Medical Imaging
Background:
- A 53-year-old male patient underwent percutaneous coronary intervention (PCI) for left circumflex artery (LCX) disease.
- The patient had a prior PCI of the left anterior descending (LAD) artery six months earlier.
Observation:
- During optical coherence tomography (OCT) catheter delivery to the LAD, it dislodged from the guidewire and impacted the LCX ostium.
- This complication occurred at a bifurcation with an eccentric lesion.
Findings:
- The OCT catheter dislodgement, termed "railed-off", posed a significant risk during the procedure.
- Successful patient stabilization was achieved after guide-catheter repositioning and double-kissing culotte stenting at the left main bifurcation.
Implications:
- Highlights the genuine and serious risk of OCT catheter "railed-off" events.
- Emphasizes the need for meticulous OCT catheter delivery techniques.
- Suggests potential improvements in OCT catheter design to mitigate such complications.
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