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Chapters (9)
Description
Date : Monday, November 30th -0001 from 12am to 12am (GMT+2)
Honolulu : Monday, November 29th 1999 from 12pm to 12pm (GMT-10)
San Francisco : Monday, November 29th 1999 from 02pm to 02pm (GMT-8)
New York : Monday, November 29th 1999 from 05pm to 05pm (GMT-5)
Buenos Aires : Monday, November 29th 1999 from 07pm to 07pm (GMT-3)
London / Dublin : Monday, November 29th 1999 from 10pm to 10pm (GMT)
Paris / Berlin : Monday, November 29th 1999 from 11pm to 11pm (GMT+1)
Istanbul : Tuesday, November 30th 1999 from 12am to 12am (GMT+2)
Moscou / Dubaï : Tuesday, November 30th 1999 from 02am to 02am (GMT+4)
Bangkok : Tuesday, November 30th 1999 from 05am to 05am (GMT+7)
Shanghai : Tuesday, November 30th 1999 from 06am to 06am (GMT+8)
Tokyo : Tuesday, November 30th 1999 from 07am to 07am (GMT+9)
Sydney : Tuesday, November 30th 1999 from 08am to 08am (GMT+10)
Wellington : Tuesday, November 30th 1999 from 10am to 10am (GMT+12)
Last update : 2019-05-28
Language(s) : English
Views : 16584
This complete didactic procedure concerns a 41 yo male, with multiple cardiovascular risk factors, presenting severe excertional angin...
This complete didactic procedure concerns a 41 yo male, with multiple cardiovascular risk factors, presenting severe excertional angina related to ostial LAD chronic total occlusion.
The LAD CTO was successfully recanalized antegradly using IVUS guided-puncture Technique & Bifurcation Stenting LAD-D1 with DK-Crush Technique.

Educational objectives

  • How to manage diabetic patients with one vessel disease (Proximal LAD CTO): CABG vs PCI.
  • Step-by-Step setup & Access-guiding catheters choice.
  • Application of the Hybrid algorithm in CTO PCI procedures.
  • IVUS guided proximal  CAP puncture technique.
  • Tips & Tricks to gain support and safely advance microcatheters, balloons...in uncrossable lesions.
  • How to Stent bifurcations in CTO lesions.
  • How to perform double Stent Technique: DK-Crush.
  • How to prevent complications during every Step CTO PCI procedure.

Step-by-Step procedure

  • Dual Femoral Access : 8F introducer in Right CFA & 7F introducer in Left CFA.
  • JR 7F  guiding catheter for the RCA & 8F EBU3.0 for the Left main.
  • Proximal CAP engagment using Workhorse guidewire Sionblue (Asahi) then Fielder XT-A (Asahi) & Low profile microcatheter Caravel (Asahi).
  • Advancement of the Filder XT-R into the first diagonal.
  • Trapping the microcather with Trapping dedicated Device: Trapper (Boston Scientific).
  • Predilation toward the Diagonal with small balloon 1.5x20mm.
  • Exchange of the Fielder XT-A (Asahi) with a workhorse guidewire Sionblue (Asahi).
  • IVUS evaluation of the proximal CAP.
  • Echo-guided puncture using a Fielder XT-A Guidewire & Caravel microcatheter (Asahi).
  • Exchange Fielder XT-A guidewire to Gaia Second (Asahi) to cross the occlusion & angiographic control in two orthogonal views.
  • Anchoring balloon technique in the diagonal to advance the Caravel into the LAD.
  • After failing the Anchoring balloon technique, a dilatation of the proximal Cap using a small balloon 1.5x20mm was performed.
  • Exchange  to the microcatheter & Crossing into the true lumen using a workhorse guidewire Runthrough guidewire (Terumo).
  • Predilatation of the Diagonal & the LAD with  2.5x15mm.
  • Angiographic control.
  • Bifurcation two stents technique: LAD-1st Diagonal with DK-Crush Technique.

Biobliography

CTO technics

Linked playlists (4)

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Comments(7)
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  • Amir ali M. nice job

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    • Naga ganesh K. Great

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      • Mochamad Faishal R. Excellent technique

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        • Pierre D. very educational case

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          • hazem E. excellent comprehensive presentation to the point clear steps

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            • Venkatesa R. very good

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              • Tekten T. thanks

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                Monday, November 16th 2020 from 06pm to 07:15pm (GMT+2)
                Honolulu : Monday, November 16th 2020 from 06am to 07:15am (GMT-10)
                San Francisco : Monday, November 16th 2020 from 08am to 09:15am (GMT-8)
                New York : Monday, November 16th 2020 from 11am to 12:15pm (GMT-5)
                Buenos Aires : Monday, November 16th 2020 from 01pm to 02:15pm (GMT-3)
                London / Dublin : Monday, November 16th 2020 from 04pm to 05:15pm (GMT)
                Paris / Berlin : Monday, November 16th 2020 from 05pm to 06:15pm (GMT+1)
                Istanbul : Monday, November 16th 2020 from 06pm to 07:15pm (GMT+2)
                Moscou / Dubaï : Monday, November 16th 2020 from 08pm to 09:15pm (GMT+4)
                Bangkok : Monday, November 16th 2020 from 11pm to 12:15am (GMT+7)
                Shanghai : Tuesday, November 17th 2020 from 12am to 01:15am (GMT+8)
                Tokyo : Tuesday, November 17th 2020 from 01am to 02:15am (GMT+9)
                Sydney : Tuesday, November 17th 2020 from 02am to 03:15am (GMT+10)
                Wellington : Tuesday, November 17th 2020 from 04am to 05:15am (GMT+12)

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                Tuesday, December 22nd 2020 from 12pm to 01:15pm (GMT+2)
                Honolulu : Tuesday, December 22nd 2020 from 12am to 01:15am (GMT-10)
                San Francisco : Tuesday, December 22nd 2020 from 02am to 03:15am (GMT-8)
                New York : Tuesday, December 22nd 2020 from 05am to 06:15am (GMT-5)
                Buenos Aires : Tuesday, December 22nd 2020 from 07am to 08:15am (GMT-3)
                London / Dublin : Tuesday, December 22nd 2020 from 10am to 11:15am (GMT)
                Paris / Berlin : Tuesday, December 22nd 2020 from 11am to 12:15pm (GMT+1)
                Istanbul : Tuesday, December 22nd 2020 from 12pm to 01:15pm (GMT+2)
                Moscou / Dubaï : Tuesday, December 22nd 2020 from 02pm to 03:15pm (GMT+4)
                Bangkok : Tuesday, December 22nd 2020 from 05pm to 06:15pm (GMT+7)
                Shanghai : Tuesday, December 22nd 2020 from 06pm to 07:15pm (GMT+8)
                Tokyo : Tuesday, December 22nd 2020 from 07pm to 08:15pm (GMT+9)
                Sydney : Tuesday, December 22nd 2020 from 08pm to 09:15pm (GMT+10)
                Wellington : Tuesday, December 22nd 2020 from 10pm to 11:15pm (GMT+12)

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                Saturday, November 9th 2019 from 09am to 11am (GMT+2)
                Honolulu : Friday, November 8th 2019 from 09pm to 11pm (GMT-10)
                San Francisco : Friday, November 8th 2019 from 11pm to 01am (GMT-8)
                New York : Saturday, November 9th 2019 from 02am to 04am (GMT-5)
                Buenos Aires : Saturday, November 9th 2019 from 04am to 06am (GMT-3)
                London / Dublin : Saturday, November 9th 2019 from 07am to 09am (GMT)
                Paris / Berlin : Saturday, November 9th 2019 from 08am to 10am (GMT+1)
                Istanbul : Saturday, November 9th 2019 from 09am to 11am (GMT+2)
                Moscou / Dubaï : Saturday, November 9th 2019 from 11am to 01pm (GMT+4)
                Bangkok : Saturday, November 9th 2019 from 02pm to 04pm (GMT+7)
                Shanghai : Saturday, November 9th 2019 from 03pm to 05pm (GMT+8)
                Tokyo : Saturday, November 9th 2019 from 04pm to 06pm (GMT+9)
                Sydney : Saturday, November 9th 2019 from 05pm to 07pm (GMT+10)
                Wellington : Saturday, November 9th 2019 from 07pm to 09pm (GMT+12)

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                Tuesday, December 3rd 2019 from 12:30pm to 02pm (GMT+2)
                Honolulu : Tuesday, December 3rd 2019 from 12:30am to 02am (GMT-10)
                San Francisco : Tuesday, December 3rd 2019 from 02:30am to 04am (GMT-8)
                New York : Tuesday, December 3rd 2019 from 05:30am to 07am (GMT-5)
                Buenos Aires : Tuesday, December 3rd 2019 from 07:30am to 09am (GMT-3)
                London / Dublin : Tuesday, December 3rd 2019 from 10:30am to 12pm (GMT)
                Paris / Berlin : Tuesday, December 3rd 2019 from 11:30am to 01pm (GMT+1)
                Istanbul : Tuesday, December 3rd 2019 from 12:30pm to 02pm (GMT+2)
                Moscou / Dubaï : Tuesday, December 3rd 2019 from 02:30pm to 04pm (GMT+4)
                Bangkok : Tuesday, December 3rd 2019 from 05:30pm to 07pm (GMT+7)
                Shanghai : Tuesday, December 3rd 2019 from 06:30pm to 08pm (GMT+8)
                Tokyo : Tuesday, December 3rd 2019 from 07:30pm to 09pm (GMT+9)
                Sydney : Tuesday, December 3rd 2019 from 08:30pm to 10pm (GMT+10)
                Wellington : Tuesday, December 3rd 2019 from 10:30pm to 12am (GMT+12)

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                Wednesday, March 10th 2021 from 06:30pm to 07:30pm (GMT+2)
                Honolulu : Wednesday, March 10th 2021 from 06:30am to 07:30am (GMT-10)
                San Francisco : Wednesday, March 10th 2021 from 08:30am to 09:30am (GMT-8)
                New York : Wednesday, March 10th 2021 from 11:30am to 12:30pm (GMT-5)
                Buenos Aires : Wednesday, March 10th 2021 from 01:30pm to 02:30pm (GMT-3)
                London / Dublin : Wednesday, March 10th 2021 from 04:30pm to 05:30pm (GMT)
                Paris / Berlin : Wednesday, March 10th 2021 from 05:30pm to 06:30pm (GMT+1)
                Istanbul : Wednesday, March 10th 2021 from 06:30pm to 07:30pm (GMT+2)
                Moscou / Dubaï : Wednesday, March 10th 2021 from 08:30pm to 09:30pm (GMT+4)
                Bangkok : Wednesday, March 10th 2021 from 11:30pm to 12:30am (GMT+7)
                Shanghai : Thursday, March 11th 2021 from 12:30am to 01:30am (GMT+8)
                Tokyo : Thursday, March 11th 2021 from 01:30am to 02:30am (GMT+9)
                Sydney : Thursday, March 11th 2021 from 02:30am to 03:30am (GMT+10)
                Wellington : Thursday, March 11th 2021 from 04:30am to 05:30am (GMT+12)

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                Thursday, July 9th 2020 from 08am to 10pm (GMT+2)
                Honolulu : Wednesday, July 8th 2020 from 08pm to 10am (GMT-10)
                San Francisco : Wednesday, July 8th 2020 from 11pm to 01pm (GMT-7)
                New York : Thursday, July 9th 2020 from 02am to 04pm (GMT-4)
                Buenos Aires : Thursday, July 9th 2020 from 03am to 05pm (GMT-3)
                Reykjavik : Thursday, July 9th 2020 from 06am to 08pm (GMT)
                London / Dublin : Thursday, July 9th 2020 from 07am to 09pm (GMT+1)
                Paris / Berlin : Thursday, July 9th 2020 from 08am to 10pm (GMT+2)
                Istanbul : Thursday, July 9th 2020 from 09am to 11pm (GMT+3)
                Moscou / Dubaï : Thursday, July 9th 2020 from 10am to 12am (GMT+4)
                Bangkok : Thursday, July 9th 2020 from 01pm to 03am (GMT+7)
                Shanghai : Thursday, July 9th 2020 from 02pm to 04am (GMT+8)
                Tokyo : Thursday, July 9th 2020 from 03pm to 05am (GMT+9)
                Sydney : Thursday, July 9th 2020 from 05pm to 07am (GMT+11)
                Wellington : Thursday, July 9th 2020 from 07pm to 09am (GMT+13)

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                Tuesday, June 23rd 2020 from 05pm to 06:30pm (GMT+2)
                Honolulu : Tuesday, June 23rd 2020 from 05am to 06:30am (GMT-10)
                San Francisco : Tuesday, June 23rd 2020 from 08am to 09:30am (GMT-7)
                New York : Tuesday, June 23rd 2020 from 11am to 12:30pm (GMT-4)
                Buenos Aires : Tuesday, June 23rd 2020 from 12pm to 01:30pm (GMT-3)
                Reykjavik : Tuesday, June 23rd 2020 from 03pm to 04:30pm (GMT)
                London / Dublin : Tuesday, June 23rd 2020 from 04pm to 05:30pm (GMT+1)
                Paris / Berlin : Tuesday, June 23rd 2020 from 05pm to 06:30pm (GMT+2)
                Istanbul : Tuesday, June 23rd 2020 from 06pm to 07:30pm (GMT+3)
                Moscou / Dubaï : Tuesday, June 23rd 2020 from 07pm to 08:30pm (GMT+4)
                Bangkok : Tuesday, June 23rd 2020 from 10pm to 11:30pm (GMT+7)
                Shanghai : Tuesday, June 23rd 2020 from 11pm to 12:30am (GMT+8)
                Tokyo : Wednesday, June 24th 2020 from 12am to 01:30am (GMT+9)
                Sydney : Wednesday, June 24th 2020 from 02am to 03:30am (GMT+11)
                Wellington : Wednesday, June 24th 2020 from 04am to 05:30am (GMT+13)

                Approaching Complex CTOs via radial access

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                Thursday, June 25th 2020 from 05pm to 06:30pm (GMT+2)
                Honolulu : Thursday, June 25th 2020 from 05am to 06:30am (GMT-10)
                San Francisco : Thursday, June 25th 2020 from 08am to 09:30am (GMT-7)
                New York : Thursday, June 25th 2020 from 11am to 12:30pm (GMT-4)
                Buenos Aires : Thursday, June 25th 2020 from 12pm to 01:30pm (GMT-3)
                Reykjavik : Thursday, June 25th 2020 from 03pm to 04:30pm (GMT)
                London / Dublin : Thursday, June 25th 2020 from 04pm to 05:30pm (GMT+1)
                Paris / Berlin : Thursday, June 25th 2020 from 05pm to 06:30pm (GMT+2)
                Istanbul : Thursday, June 25th 2020 from 06pm to 07:30pm (GMT+3)
                Moscou / Dubaï : Thursday, June 25th 2020 from 07pm to 08:30pm (GMT+4)
                Bangkok : Thursday, June 25th 2020 from 10pm to 11:30pm (GMT+7)
                Shanghai : Thursday, June 25th 2020 from 11pm to 12:30am (GMT+8)
                Tokyo : Friday, June 26th 2020 from 12am to 01:30am (GMT+9)
                Sydney : Friday, June 26th 2020 from 02am to 03:30am (GMT+11)
                Wellington : Friday, June 26th 2020 from 04am to 05:30am (GMT+13)

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