Abstract book 6th RMS 16.indd

death were 3.7% and 0% respectively,
while at 6 months frequency of MACE and
death was 9.3% and 0.8% respectively.
Conclusion: All antegrade PCIs on CTOs
are safe at our tertiary referral centre
with an acceptable success rate that
improved with the acquisition of CTO
dedicated equipments and gaining of
experience along two consecutive years.
Performing less ad-hocs, providing extra
time allowance for operators, using more
specialized devices, enhancing second
attempts and performing retrograde
techniques may increase the success rates
further more in the future.
332
Experience with Transradial
Sheathless Guiding Catheters at
Queen Alia Heart
Institute Initial Experience in Jordan
Abdallah Omeish MD*, Shadwan Al-Fakeeh ,
Ziad Drabaa, Wasfi Abbadi, Raed Alamlih,
* Consultant Interventional Cardiologist QAHI
(Jordan)
abdallah.omeish@yahoo.com
Objectives: to describe the use of
sheathless guiding catheters in performing
complex coronary artery percutaneous
interventions via transradial approach.
The use of such catheters had never been
described in Jordan previously.
Methods: A prospective cohort study
on a total of five patients (4 M, 1 F)
with mean age of 65.8 years and BMI of
22.6, who underwent complex coronary
percutaneous interventions using 7.5
sheathless guiding catheters at Queen
Alia Heart Institute. Selection of patients
among the whole transradial population
performed by the group was done at
the operator’s discretion when the radial
artery diameter was felt too small to
accommodate standard 7 French sheath .
Results: Two patients underwent minicrush
stenting of 1, 1, 1 Medina LAD/
D1 lesions. The third patient underwent
unprotected bifurcation left main stenting
using TAP technique. The fourth patient
underwent draw back T stenting of 0,
0, 1 Medina ostial obtuse marginal one
lesion using anchoring balloon in the
native circumflex artery. The last patient
underwent successful recanalization of
a chronically occluded mid LAD using
penetration with parallel wire techniques
aided by side branch balloon support
technique.
Conclusion: Sheathless guiding catheters
allowed complex interventions requiring
large bore catheters to be performed
transradially . Therefore these guides are
now considered an essential component
among the transradial armamentarium in
our cath lab.
Hall C Session 3
Cardiology
333
Non-Cardiac Surgery after Stenting:
When it will be Appropriate?
Wael Husami MD (USA)
Major adverse cardiovascular events
(MACE) and/or hemorrhagic complications
have been a concern since the introduction
of coronary stenting in 1986. Poor clinical
outcomes usually occur despite successful
restoration of blood flow. The combined
end point of death and non-fatal MI exceed
70%. Risk factors for acute and subacute
stent thrombosis are multifactorial
in origin such as stent, patient and/
or operator factors. Surgery increase
risk of perioperative stent thrombosis
by increasing the plasma procoagulant
activity which could increase the tendency
for thrombosis. For patients who undergo
successful coronary intervention with or
without stent placement before planned
noncardiac surgery, there is uncertainty
regarding how much time should pass
before the non-cardiac procedure is
performed, primarily because of the fear
of stent thrombosis.
The published current ACC/AHA PCI and
CABG guidelines considered coronary
revascularization before noncardiac
surgery as Class I indication in patients
with stable angina who have significant
left main artery disease, 3-vessel disease
or have 2-vessel disease with significant
proximal LAD stenosis and either EF
less than 0.50 as well as in patient with
acute myocardial infarction. In the other
hand, A 2007 AHA/ACC/SCAI/ACS/
ADA science advisory report concludes
that premature discontinuation of dual-
www.jrms.gov.jo
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