Academic Updates | Dr. Lei Song of Fuwai Hospital Performs Complex CTO Demonstration Surgery in Indonesia
🔹 Event Overview Recently, at the invitation of MRCCC Siloam Semanggi Hospital in Jakarta, Indonesia, Dr. Lei Song, Chief Physician from Fuwai Hospital, Chinese Academy of Medical Sciences, traveled to the region to conduct complex Chronic Total Occlusion (CTO) surgical demonstrations.
A total of 3 complex CTO interventions were completed during this exchange, with a live broadcast to physicians across multiple countries, including Singapore, Indonesia, and Malaysia.
🔹 High-Difficulty Case Challenge In one of the demonstration cases, the patient was a 34-year-old male presenting with a CTO in the Right Coronary Artery (RCA).
The occluded segment was long and accompanied by a hard fibrous cap. The anatomical conditions were extremely complex, and multiple previous recanalization attempts locally had failed.
🔹 DSA and IVUS Imaging Support The surgery was performed jointly by experts from China and Indonesia. Dual imaging guidance was utilized during the procedure, featuring United Imaging's zero-noise DSA system and IVUS (Intravascular Ultrasound).
The high-definition and low-noise characteristics of the DSA effectively eliminated background interference, clearly visualizing the intricate collateral circulation network.
Simultaneously, IVUS precisely identified the anatomical structure of the occluded segment and the trajectory of the true lumen, providing crucial imaging evidence for subsequent maneuvers.
🔹 Microcatheter-Assisted Recanalization Technique To address the hard proximal fibrous cap and ambiguous entry point, the operators employed an antegrade dual-lumen microcatheter-assisted precise guidewire puncture technique.
With the strong lateral support and precise guidewire orientation provided by the dual-lumen microcatheter, the guidewire successfully penetrated the calcified/fibrotic tissue, finding and entering the distal true lumen.
🔹 Revascularization Achieved Following successful vessel recanalization, the team sequentially utilized a Drug-Coated Balloon (DCB) to complete the revascularization.
Final angiography demonstrated that the RCA successfully restored TIMI 3 (complete perfusion) flow.
🔹 Future Clinical Training Plans This event focused on in-depth discussions regarding strategy formulation, device selection, and the application of intravascular imaging tools in CTO interventions.
Moving forward, both parties plan to continuously share standardized operational procedures and clinical experiences in complex coronary interventions through regular surgical demonstrations, online case discussions, and physician fellowship programs.
