https://twitter.com/Updock/status/862316985199329283
It was great to see live cases back at #SCAI2017.
Discussion began with a calcified distal left main case, where Dr. David Rizik demonstrated treatment of a distal LM bifurcation. A strategy of "mini-SKS" was used to stent the LM, with great result.
The second case, with Dr. Lombardi was a #CTO of the LAD following complex bifurcation PCI of a LCx / OM lesion, demonstrated several helpful techniques:
Use of a microcatheter for traversing the CTO was emphasized, and was described as the "standard of care" for current CTO treatment. Use of a "Trapper" balloon was demonstrated. Given the complexity of the lesion in the LAD, rotational atherectomy was also used to modify the plaque. There is still need for further evaluation of small DES stenting vs. drug coated balloons and deferred PCI in CTO.
A third case of Dr. Alok Sharma's, was a LM intervention using a 7Fr Slender, #radialfirst approach highlighted the techniques of transradial, left main, angioplasty using rotational atherectomy through a XB guide. This was performed in a high-risk Jehovah's Witness with thrombocytopenia, in whom bleeding risk reduction was of paramount importance.
IVUS was used to confirm placement and deployment.
"You can do this from the wrist." - Dr. Rizik
Use of plaque modification, IVUS, and the use of a heart team approach featured prominently in all three cases. These cases highlighted the types of techniques which can be used in high-risk, surgical-type patients, with excellent results.
Jeffrey M. Schussler, MD, FACC, FSCAI
@Updock
#SCAI2017
CHIP / CTO
Live Cases
It was great to see live cases back at #SCAI2017.
Discussion began with a calcified distal left main case, where Dr. David Rizik demonstrated treatment of a distal LM bifurcation. A strategy of "mini-SKS" was used to stent the LM, with great result.
The second case, with Dr. Lombardi was a #CTO of the LAD following complex bifurcation PCI of a LCx / OM lesion, demonstrated several helpful techniques:
Use of a microcatheter for traversing the CTO was emphasized, and was described as the "standard of care" for current CTO treatment. Use of a "Trapper" balloon was demonstrated. Given the complexity of the lesion in the LAD, rotational atherectomy was also used to modify the plaque. There is still need for further evaluation of small DES stenting vs. drug coated balloons and deferred PCI in CTO.
A third case of Dr. Alok Sharma's, was a LM intervention using a 7Fr Slender, #radialfirst approach highlighted the techniques of transradial, left main, angioplasty using rotational atherectomy through a XB guide. This was performed in a high-risk Jehovah's Witness with thrombocytopenia, in whom bleeding risk reduction was of paramount importance.
"You can do this from the wrist." - Dr. Rizik
Use of plaque modification, IVUS, and the use of a heart team approach featured prominently in all three cases. These cases highlighted the types of techniques which can be used in high-risk, surgical-type patients, with excellent results.
Jeffrey M. Schussler, MD, FACC, FSCAI
@Updock
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