Treatment of multi-vessel coronary artery disease in young patient using transradial

approach

Pejkov H, Kalpak O, Kostov J, Spirovski I, Antov S, Kedev S.

Laboratory for Interventional Cardiology, University Clinic of Cardiology, Faculty of Medicine, Ss Cyril and Methodius, University,

Republic of Macedonia

I have nothing to disclose

PATIENT CHARACTERISTICS

General: AI, 34, Male

Presentation: chest pain during exertion

Hemodynamic/respiratory status: Stable

Risk factors for CAD: Hyperlipidemia, Smoker, DM

Life style: Sedentary

Psychological status: Normal

Past medical history: No

EET was performed and interrupted after 5 minutes due to chest pain and ST segment depression in V4-V6 of 2 mm.

Echocardiography showed normal kinetics of the left chamber with EF 65% and present mitral insufficiency of second degree.

34 y.o. male:

ChallengeChallenge

To show the benefit and safety of percutaneous coronary interventions in young patients with multi-vessel coronary disease using transradial

approach

Transradial access LAD-100%

OM 100 % RCA 95%

Pharmacological treatment: ASA/Clopidogrel preloadUFH- 10000 IU

Strategy:- Guide catheter (EBU 3,5 - 6F size,RJ3.5-6 F size, right radial access)- Wires (one CTO wire to LAD and BMW in Diag, one CTO wire in OM , BMW wire to RCA)

-Stenting ( DES 3.0/38mm LAD, DES 3.0/30mm OM, DES 2.5/19 RCA)-Postdilatation: (NC balloon)

PCI+Stenting LADPCI+Stenting LADDES 3.0-38mmDES 3.0-38mm

PCI+Stenting OMPCI+Stenting OMDES 3.0-30mmDES 3.0-30mm

PCI+Stenting RCAPCI+Stenting RCADES 2.5-19mmDES 2.5-19mm

Complete revascularisationComplete revascularisation

Conclusion

Transradial approach is safe and beneficial by complex coronary intervention when is performed by experienced transradial operator

Conclusion

Patent haemostasis is essential for repeated wrist procedures such as staged treatment of multivessel disease.