Korean Circ J.  2020 Sep;50(9):839-842. 10.4070/kcj.2020.0058.

Unpredictable Midterm Coronary Damage after Knuckle-reverse CART: Should We Be More Careful?

• Levesque S
• Gaufroy A
• Gamet A
• Motreff P
• Christiaens LP

• KMID: 2505741
• DOI: http://doi.org/10.4070/kcj.2020.0058

Figure

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  Figure 1 (A, F, K) Right coronary artery with proximal chronic total occlusion. (B, G, L) Immediate perfect angiographic result after successful CTO PCI using the reverse CART technique. (C, H, M) Immediate OFDI result. Stents are well apposed everywhere. Some struts are deeply impacted in the media which seems to be heterogenous (thrombus, haematoma or scar of dissection?). (D, I, N) One-month systematic angiographic control showing several aneurysms in the reverse CART target zone (arrows). (E, J, O) One-month systematic OFDI control showing large and circumferential acquired stent malapposition. Stents are perfectly deployed without underexpansion (mean diameters are equal to the initial stent size, A4 SMD: 3.6 mm; B4 SMD: 3.6 mm; C4 SMD: 4.1 mm). Stent struts appear to be free of thrombus or neoendothelium. The vessel lumen area increased abnormally with a mean diameter compatible to acquired shredding aneurysms (A4 LMD: 6.2 mm; B4 LMD: 5.9 mm; C4 LMD: 5.4 mm).CART = Controlled Anterograde and Retrograde Tracking; CTO = chronic total occlusion; LMD = lumen mean diameter; OFDI = Optical Frequency Domain Imaging; PCI = Percutaneous Coronary Intervention; SMD = stent mean diameter.

Reference

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