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Chapters (10)
Description
Date : Friday, June 29th 2018 from 09:40am to 11am (GMT+1)
Honolulu : Thursday, June 28th 2018 from 10:40pm to 12am (GMT-10)
San Francisco : Friday, June 29th 2018 from 01:40am to 03am (GMT-7)
New York : Friday, June 29th 2018 from 04:40am to 06am (GMT-4)
Buenos Aires : Friday, June 29th 2018 from 05:40am to 07am (GMT-3)
Reykjavik : Friday, June 29th 2018 from 08:40am to 10am (GMT)
London / Dublin : Friday, June 29th 2018 from 09:40am to 11am (GMT+1)
Paris / Berlin : Friday, June 29th 2018 from 10:40am to 12pm (GMT+2)
Istanbul : Friday, June 29th 2018 from 11:40am to 01pm (GMT+3)
Moscou / Dubaï : Friday, June 29th 2018 from 12:40pm to 02pm (GMT+4)
Bangkok : Friday, June 29th 2018 from 03:40pm to 05pm (GMT+7)
Shanghai : Friday, June 29th 2018 from 04:40pm to 06pm (GMT+8)
Tokyo : Friday, June 29th 2018 from 05:40pm to 07pm (GMT+9)
Sydney : Friday, June 29th 2018 from 07:40pm to 09pm (GMT+11)
Wellington : Friday, June 29th 2018 from 09:40pm to 11pm (GMT+13)
Last update : 2018-12-19
Language(s) : English
Views : 20650

This complete didactic procedure concerns a 72 yo male, with history of lateral STEMI (OM Stenting). The coronary angiography has also...

This complete didactic procedure concerns a 72 yo male, with history of lateral STEMI (OM Stenting). The coronary angiography has also shown proximal RCA Chronic total occlusion with residual proven ischemia.

This RCA Chronic total occlusion was recanalized antegradly using antegrade-dissection-reentry (ADR) technique explained step-by-step by a Proctor expert in ADR.

Educational objectives

  • How to manage patients with Coronary Chronic total occlusions.
  • How to  plan intervention strategy using the Hybrid algorithm.
  • How to perform Knuckle wire technique.
  • Optimal application of the  antergrade controlled dissecion using the CossBoss microcatheter.
  • Optimal preparation of the Stingray balloon.
  • How to perform reentry technique with Stingray guidewire.
  • Proctoring importance in optimal learning  curve of ADR technique.

Step-by-Step procedure

  • Dual Radial access : Left Radial 7F for the right & Right radial 6F for the left system.
  • AL0.75 7F in the RCA & EBU 4.0 6F in the LM.
  • Dual lumen injections and angiographic studying of the lesion (Proximal CAP, Length, Distal vessel, Collaterals).
  • Approach :antegrade wire escalation, if failed : Antegrade-Dissection-reentry as first strategy.
  • Pilot 200 Guidewire with a MAMBA  microcatheter (Boston Scientific) failed to engage the Proximal CAP.
  • Engaging the Proximal CAP with Confianza Pro 12 guidewire.and switch again to Pilot200.
  • Advancing the Pilot 200 as Knuckle wire Technique.
  • Retreiving the MAMBA microcatheter using the Trapper Catheter (Boston Scientific) to limit the risk of significant hematoma.
  • Advancing the CrosBoss catheter in the subintimal space with Pilot 200 guidewire inside.
  • Stingray preparation while CrossBoss is in the Subintimal space.
  • Retreiving the CrosBoss Catheter using the Trapper and advancing the Stingray balloon.
  • Getting the optimal Stingray Projection for reentry.
  • Reentry technque using the Stingray guidewire.
  • Retreiving the Stingray balloon using Trapper & Advancing the MAMBA microcatheter over the Stingray guidewire.
  • Advancing a regular guidewire to the distal RCA.
  • Predilatation with a 4.0x20mm.
  • Stenting with two 4.0x38mm Synergy stents. and additional 4.0x24mm Synergy stent.

Biobliography

 

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Comments(12)
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See previous comments (7)
  • abdallah A. too much metal for a rather shorter lesion !!!!!

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    • mariwan S. GREAT JOB WELL DONE
      What was the cause of ostial dissection ?

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      • Marc H. Could you have pulled your retrograde gear once your wire was in the true lumen

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        • Bijan B. What happened to larg marginal branch

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          • Amr A. what about 7fr sheath on transradial
            do you need pre procedure radial duplex or angio

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            • Anselmo B. The right ventricular branches were all occluded. They didn’t try to recanalize anterograde, really possible, in my experience. Subintimal is a last resource

              • Serob M. I guess it has retrograde flow :)

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            • Narinder B. Why do you Need to be so Farm to reenter

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              • ahmed S. excellent

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                • Phatarpekar A. Naice

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                  • Serob M. Thomas Hovasse, super!

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                    • Mohammed H. excellent case

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                      Wednesday, December 13th 2017 from 12:30pm to 02pm (GMT+1)
                      Honolulu : Wednesday, December 13th 2017 from 01:30am to 03am (GMT-10)
                      San Francisco : Wednesday, December 13th 2017 from 03:30am to 05am (GMT-8)
                      New York : Wednesday, December 13th 2017 from 06:30am to 08am (GMT-5)
                      Buenos Aires : Wednesday, December 13th 2017 from 08:30am to 10am (GMT-3)
                      London / Dublin : Wednesday, December 13th 2017 from 11:30am to 01pm (GMT)
                      Paris / Berlin : Wednesday, December 13th 2017 from 12:30pm to 02pm (GMT+1)
                      Istanbul : Wednesday, December 13th 2017 from 01:30pm to 03pm (GMT+2)
                      Moscou / Dubaï : Wednesday, December 13th 2017 from 03:30pm to 05pm (GMT+4)
                      Bangkok : Wednesday, December 13th 2017 from 06:30pm to 08pm (GMT+7)
                      Shanghai : Wednesday, December 13th 2017 from 07:30pm to 09pm (GMT+8)
                      Tokyo : Wednesday, December 13th 2017 from 08:30pm to 10pm (GMT+9)
                      Sydney : Wednesday, December 13th 2017 from 09:30pm to 11pm (GMT+10)
                      Wellington : Wednesday, December 13th 2017 from 11:30pm to 01am (GMT+12)

                      Expand your frontiers in transradial PCI: The sheathless approach

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                      Wednesday, October 31st 2018 from 12:30pm to 02pm (GMT+1)
                      Honolulu : Wednesday, October 31st 2018 from 01:30am to 03am (GMT-10)
                      San Francisco : Wednesday, October 31st 2018 from 03:30am to 05am (GMT-8)
                      New York : Wednesday, October 31st 2018 from 06:30am to 08am (GMT-5)
                      Buenos Aires : Wednesday, October 31st 2018 from 08:30am to 10am (GMT-3)
                      London / Dublin : Wednesday, October 31st 2018 from 11:30am to 01pm (GMT)
                      Paris / Berlin : Wednesday, October 31st 2018 from 12:30pm to 02pm (GMT+1)
                      Istanbul : Wednesday, October 31st 2018 from 01:30pm to 03pm (GMT+2)
                      Moscou / Dubaï : Wednesday, October 31st 2018 from 03:30pm to 05pm (GMT+4)
                      Bangkok : Wednesday, October 31st 2018 from 06:30pm to 08pm (GMT+7)
                      Shanghai : Wednesday, October 31st 2018 from 07:30pm to 09pm (GMT+8)
                      Tokyo : Wednesday, October 31st 2018 from 08:30pm to 10pm (GMT+9)
                      Sydney : Wednesday, October 31st 2018 from 09:30pm to 11pm (GMT+10)
                      Wellington : Wednesday, October 31st 2018 from 11:30pm to 01am (GMT+12)

                      CHIP : The Italian Way

                      Complex and High Risk Indicated Patients

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                      Wednesday, November 7th 2018 from 06pm to 07:30pm (GMT+1)
                      Honolulu : Wednesday, November 7th 2018 from 07am to 08:30am (GMT-10)
                      San Francisco : Wednesday, November 7th 2018 from 09am to 10:30am (GMT-8)
                      New York : Wednesday, November 7th 2018 from 12pm to 01:30pm (GMT-5)
                      Buenos Aires : Wednesday, November 7th 2018 from 02pm to 03:30pm (GMT-3)
                      London / Dublin : Wednesday, November 7th 2018 from 05pm to 06:30pm (GMT)
                      Paris / Berlin : Wednesday, November 7th 2018 from 06pm to 07:30pm (GMT+1)
                      Istanbul : Wednesday, November 7th 2018 from 07pm to 08:30pm (GMT+2)
                      Moscou / Dubaï : Wednesday, November 7th 2018 from 09pm to 10:30pm (GMT+4)
                      Bangkok : Thursday, November 8th 2018 from 12am to 01:30am (GMT+7)
                      Shanghai : Thursday, November 8th 2018 from 01am to 02:30am (GMT+8)
                      Tokyo : Thursday, November 8th 2018 from 02am to 03:30am (GMT+9)
                      Sydney : Thursday, November 8th 2018 from 03am to 04:30am (GMT+10)
                      Wellington : Thursday, November 8th 2018 from 05am to 06:30am (GMT+12)

                      Bifurcation - Multivessels - Calcifications: How to treat the complex?

                      Complex PTCA: Experts' analysis

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                      Tuesday, January 26th 2021 from 06pm to 07pm (GMT+1)
                      Honolulu : Tuesday, January 26th 2021 from 07am to 08am (GMT-10)
                      San Francisco : Tuesday, January 26th 2021 from 09am to 10am (GMT-8)
                      New York : Tuesday, January 26th 2021 from 12pm to 01pm (GMT-5)
                      Buenos Aires : Tuesday, January 26th 2021 from 02pm to 03pm (GMT-3)
                      London / Dublin : Tuesday, January 26th 2021 from 05pm to 06pm (GMT)
                      Paris / Berlin : Tuesday, January 26th 2021 from 06pm to 07pm (GMT+1)
                      Istanbul : Tuesday, January 26th 2021 from 07pm to 08pm (GMT+2)
                      Moscou / Dubaï : Tuesday, January 26th 2021 from 09pm to 10pm (GMT+4)
                      Bangkok : Wednesday, January 27th 2021 from 12am to 01am (GMT+7)
                      Shanghai : Wednesday, January 27th 2021 from 01am to 02am (GMT+8)
                      Tokyo : Wednesday, January 27th 2021 from 02am to 03am (GMT+9)
                      Sydney : Wednesday, January 27th 2021 from 03am to 04am (GMT+10)
                      Wellington : Wednesday, January 27th 2021 from 05am to 06am (GMT+12)

                      What do I do now? Managing Vessel Perforation during PCI

                      EPISODE 2: Expert discussion on bailout strategy planning and bailout technique simulation

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                      Tuesday, May 15th 2018 from 12:30pm to 02pm (GMT+1)
                      Honolulu : Tuesday, May 15th 2018 from 01:30am to 03am (GMT-10)
                      San Francisco : Tuesday, May 15th 2018 from 04:30am to 06am (GMT-7)
                      New York : Tuesday, May 15th 2018 from 07:30am to 09am (GMT-4)
                      Buenos Aires : Tuesday, May 15th 2018 from 08:30am to 10am (GMT-3)
                      Reykjavik : Tuesday, May 15th 2018 from 11:30am to 01pm (GMT)
                      London / Dublin : Tuesday, May 15th 2018 from 12:30pm to 02pm (GMT+1)
                      Paris / Berlin : Tuesday, May 15th 2018 from 01:30pm to 03pm (GMT+2)
                      Istanbul : Tuesday, May 15th 2018 from 02:30pm to 04pm (GMT+3)
                      Moscou / Dubaï : Tuesday, May 15th 2018 from 03:30pm to 05pm (GMT+4)
                      Bangkok : Tuesday, May 15th 2018 from 06:30pm to 08pm (GMT+7)
                      Shanghai : Tuesday, May 15th 2018 from 07:30pm to 09pm (GMT+8)
                      Tokyo : Tuesday, May 15th 2018 from 08:30pm to 10pm (GMT+9)
                      Sydney : Tuesday, May 15th 2018 from 10:30pm to 12am (GMT+11)
                      Wellington : Wednesday, May 16th 2018 from 12:30am to 02am (GMT+13)

                      La coronaire à la parisienne : de l'aigüe au chronique

                      Réseau de l'ASAHP

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                      Tuesday, June 12th 2018 from 02:15pm to 04:15pm (GMT+1)
                      Honolulu : Tuesday, June 12th 2018 from 03:15am to 05:15am (GMT-10)
                      San Francisco : Tuesday, June 12th 2018 from 06:15am to 08:15am (GMT-7)
                      New York : Tuesday, June 12th 2018 from 09:15am to 11:15am (GMT-4)
                      Buenos Aires : Tuesday, June 12th 2018 from 10:15am to 12:15pm (GMT-3)
                      Reykjavik : Tuesday, June 12th 2018 from 01:15pm to 03:15pm (GMT)
                      London / Dublin : Tuesday, June 12th 2018 from 02:15pm to 04:15pm (GMT+1)
                      Paris / Berlin : Tuesday, June 12th 2018 from 03:15pm to 05:15pm (GMT+2)
                      Istanbul : Tuesday, June 12th 2018 from 04:15pm to 06:15pm (GMT+3)
                      Moscou / Dubaï : Tuesday, June 12th 2018 from 05:15pm to 07:15pm (GMT+4)
                      Bangkok : Tuesday, June 12th 2018 from 08:15pm to 10:15pm (GMT+7)
                      Shanghai : Tuesday, June 12th 2018 from 09:15pm to 11:15pm (GMT+8)
                      Tokyo : Tuesday, June 12th 2018 from 10:15pm to 12:15am (GMT+9)
                      Sydney : Wednesday, June 13th 2018 from 12:15am to 02:15am (GMT+11)
                      Wellington : Wednesday, June 13th 2018 from 02:15am to 04:15am (GMT+13)

                      Intensive plaque modification with rotational atherectomy and cutting balloon before DES implantatio...

                      Live case on patient with severely calcified coronary lesions

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                      Thursday, April 11th 2019 from 12:30pm to 02pm (GMT+1)
                      Honolulu : Thursday, April 11th 2019 from 01:30am to 03am (GMT-10)
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                      Buenos Aires : Thursday, April 11th 2019 from 08:30am to 10am (GMT-3)
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                      Bangkok : Thursday, April 11th 2019 from 06:30pm to 08pm (GMT+7)
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                      Sydney : Thursday, April 11th 2019 from 10:30pm to 12am (GMT+11)
                      Wellington : Friday, April 12th 2019 from 12:30am to 02am (GMT+13)

                      Designed for challenging cases - the role of ultrathin DES

                      Live from UZ Leuven, Belgium

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                      Thursday, June 4th 2020 from 05:30pm to 06:30pm (GMT+1)
                      Honolulu : Thursday, June 4th 2020 from 06:30am to 07:30am (GMT-10)
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                      New York : Thursday, June 4th 2020 from 12:30pm to 01:30pm (GMT-4)
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                      Reykjavik : Thursday, June 4th 2020 from 04:30pm to 05:30pm (GMT)
                      London / Dublin : Thursday, June 4th 2020 from 05:30pm to 06:30pm (GMT+1)
                      Paris / Berlin : Thursday, June 4th 2020 from 06:30pm to 07:30pm (GMT+2)
                      Istanbul : Thursday, June 4th 2020 from 07:30pm to 08:30pm (GMT+3)
                      Moscou / Dubaï : Thursday, June 4th 2020 from 08:30pm to 09:30pm (GMT+4)
                      Bangkok : Thursday, June 4th 2020 from 11:30pm to 12:30am (GMT+7)
                      Shanghai : Friday, June 5th 2020 from 12:30am to 01:30am (GMT+8)
                      Tokyo : Friday, June 5th 2020 from 01:30am to 02:30am (GMT+9)
                      Sydney : Friday, June 5th 2020 from 03:30am to 04:30am (GMT+11)
                      Wellington : Friday, June 5th 2020 from 05:30am to 06:30am (GMT+13)

                      Right tools for the Left Main: Imaging, Technique, Device selection

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