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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 : 15040

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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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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                      Thursday, July 4th 2019 from 02pm to 04pm (GMT+1)
                      Honolulu : Thursday, July 4th 2019 from 03am to 05am (GMT-10)
                      San Francisco : Thursday, July 4th 2019 from 06am to 08am (GMT-7)
                      New York : Thursday, July 4th 2019 from 09am to 11am (GMT-4)
                      Buenos Aires : Thursday, July 4th 2019 from 10am to 12pm (GMT-3)
                      Reykjavik : Thursday, July 4th 2019 from 01pm to 03pm (GMT)
                      London / Dublin : Thursday, July 4th 2019 from 02pm to 04pm (GMT+1)
                      Paris / Berlin : Thursday, July 4th 2019 from 03pm to 05pm (GMT+2)
                      Istanbul : Thursday, July 4th 2019 from 04pm to 06pm (GMT+3)
                      Moscou / Dubaï : Thursday, July 4th 2019 from 05pm to 07pm (GMT+4)
                      Bangkok : Thursday, July 4th 2019 from 08pm to 10pm (GMT+7)
                      Shanghai : Thursday, July 4th 2019 from 09pm to 11pm (GMT+8)
                      Tokyo : Thursday, July 4th 2019 from 10pm to 12am (GMT+9)
                      Sydney : Friday, July 5th 2019 from 12am to 02am (GMT+11)
                      Wellington : Friday, July 5th 2019 from 02am to 04am (GMT+13)

                      Simplifying antegrade wire escalation in CTO

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                      Tuesday, September 4th 2018 from 02pm to 04pm (GMT+1)
                      Honolulu : Tuesday, September 4th 2018 from 03am to 05am (GMT-10)
                      San Francisco : Tuesday, September 4th 2018 from 06am to 08am (GMT-7)
                      New York : Tuesday, September 4th 2018 from 09am to 11am (GMT-4)
                      Buenos Aires : Tuesday, September 4th 2018 from 10am to 12pm (GMT-3)
                      Reykjavik : Tuesday, September 4th 2018 from 01pm to 03pm (GMT)
                      London / Dublin : Tuesday, September 4th 2018 from 02pm to 04pm (GMT+1)
                      Paris / Berlin : Tuesday, September 4th 2018 from 03pm to 05pm (GMT+2)
                      Istanbul : Tuesday, September 4th 2018 from 04pm to 06pm (GMT+3)
                      Moscou / Dubaï : Tuesday, September 4th 2018 from 05pm to 07pm (GMT+4)
                      Bangkok : Tuesday, September 4th 2018 from 08pm to 10pm (GMT+7)
                      Shanghai : Tuesday, September 4th 2018 from 09pm to 11pm (GMT+8)
                      Tokyo : Tuesday, September 4th 2018 from 10pm to 12am (GMT+9)
                      Sydney : Wednesday, September 5th 2018 from 12am to 02am (GMT+11)
                      Wellington : Wednesday, September 5th 2018 from 02am to 04am (GMT+13)

                      Treatment of a very large calcified ostial RCA stenosis, with rotational atherectomy, supported by H...

                      Live case on a patient with a very large calcified ostial RCA stenosis

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                      Tuesday, November 27th 2018 from 02pm to 04:41pm (GMT+1)
                      Honolulu : Tuesday, November 27th 2018 from 03am to 05:41am (GMT-10)
                      San Francisco : Tuesday, November 27th 2018 from 05am to 07:41am (GMT-8)
                      New York : Tuesday, November 27th 2018 from 08am to 10:41am (GMT-5)
                      Buenos Aires : Tuesday, November 27th 2018 from 10am to 12:41pm (GMT-3)
                      London / Dublin : Tuesday, November 27th 2018 from 01pm to 03:41pm (GMT)
                      Paris / Berlin : Tuesday, November 27th 2018 from 02pm to 04:41pm (GMT+1)
                      Istanbul : Tuesday, November 27th 2018 from 03pm to 05:41pm (GMT+2)
                      Moscou / Dubaï : Tuesday, November 27th 2018 from 05pm to 07:41pm (GMT+4)
                      Bangkok : Tuesday, November 27th 2018 from 08pm to 10:41pm (GMT+7)
                      Shanghai : Tuesday, November 27th 2018 from 09pm to 11:41pm (GMT+8)
                      Tokyo : Tuesday, November 27th 2018 from 10pm to 12:41am (GMT+9)
                      Sydney : Tuesday, November 27th 2018 from 11pm to 01:41am (GMT+10)
                      Wellington : Wednesday, November 28th 2018 from 01am to 03:41am (GMT+12)

                      A long mid calcified RCA CTO with ambiguous proximal cap

                      Live case performed by Dr Avran & Dr Carlino

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                      Thursday, November 14th 2019 from 12:30pm to 02pm (GMT+1)
                      Honolulu : Thursday, November 14th 2019 from 01:30am to 03am (GMT-10)
                      San Francisco : Thursday, November 14th 2019 from 03:30am to 05am (GMT-8)
                      New York : Thursday, November 14th 2019 from 06:30am to 08am (GMT-5)
                      Buenos Aires : Thursday, November 14th 2019 from 08:30am to 10am (GMT-3)
                      London / Dublin : Thursday, November 14th 2019 from 11:30am to 01pm (GMT)
                      Paris / Berlin : Thursday, November 14th 2019 from 12:30pm to 02pm (GMT+1)
                      Istanbul : Thursday, November 14th 2019 from 01:30pm to 03pm (GMT+2)
                      Moscou / Dubaï : Thursday, November 14th 2019 from 03:30pm to 05pm (GMT+4)
                      Bangkok : Thursday, November 14th 2019 from 06:30pm to 08pm (GMT+7)
                      Shanghai : Thursday, November 14th 2019 from 07:30pm to 09pm (GMT+8)
                      Tokyo : Thursday, November 14th 2019 from 08:30pm to 10pm (GMT+9)
                      Sydney : Thursday, November 14th 2019 from 09:30pm to 11pm (GMT+10)
                      Wellington : Thursday, November 14th 2019 from 11:30pm to 01am (GMT+12)

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                      June 2017
                      Honolulu : Thursday, June 1st 2017 from 01:30am to 03am (GMT-10)
                      San Francisco : Thursday, June 1st 2017 from 04:30am to 06am (GMT-7)
                      New York : Thursday, June 1st 2017 from 07:30am to 09am (GMT-4)
                      Buenos Aires : Thursday, June 1st 2017 from 08:30am to 10am (GMT-3)
                      Reykjavik : Thursday, June 1st 2017 from 11:30am to 01pm (GMT)
                      London / Dublin : Thursday, June 1st 2017 from 12:30pm to 02pm (GMT+1)
                      Paris / Berlin : Thursday, June 1st 2017 from 01:30pm to 03pm (GMT+2)
                      Istanbul : Thursday, June 1st 2017 from 02:30pm to 04pm (GMT+3)
                      Moscou / Dubaï : Thursday, June 1st 2017 from 03:30pm to 05pm (GMT+4)
                      Bangkok : Thursday, June 1st 2017 from 06:30pm to 08pm (GMT+7)
                      Shanghai : Thursday, June 1st 2017 from 07:30pm to 09pm (GMT+8)
                      Tokyo : Thursday, June 1st 2017 from 08:30pm to 10pm (GMT+9)
                      Sydney : Thursday, June 1st 2017 from 10:30pm to 12am (GMT+11)
                      Wellington : Friday, June 2nd 2017 from 12:30am to 02am (GMT+13)

                      New Fundamentals & Perspectives in coronary stenting

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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

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                      December 2016
                      Honolulu : Thursday, December 15th 2016 from 02am to 03:30am (GMT-10)
                      San Francisco : Thursday, December 15th 2016 from 04am to 05:30am (GMT-8)
                      New York : Thursday, December 15th 2016 from 07am to 08:30am (GMT-5)
                      Buenos Aires : Thursday, December 15th 2016 from 09am to 10:30am (GMT-3)
                      London / Dublin : Thursday, December 15th 2016 from 12pm to 01:30pm (GMT)
                      Paris / Berlin : Thursday, December 15th 2016 from 01pm to 02:30pm (GMT+1)
                      Istanbul : Thursday, December 15th 2016 from 02pm to 03:30pm (GMT+2)
                      Moscou / Dubaï : Thursday, December 15th 2016 from 04pm to 05:30pm (GMT+4)
                      Bangkok : Thursday, December 15th 2016 from 07pm to 08:30pm (GMT+7)
                      Shanghai : Thursday, December 15th 2016 from 08pm to 09:30pm (GMT+8)
                      Tokyo : Thursday, December 15th 2016 from 09pm to 10:30pm (GMT+9)
                      Sydney : Thursday, December 15th 2016 from 10pm to 11:30pm (GMT+10)
                      Wellington : Friday, December 16th 2016 from 12am to 01:30am (GMT+12)

                      Demystifying the Rotablator Procedure

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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)
                      San Francisco : Thursday, April 11th 2019 from 04:30am to 06am (GMT-7)
                      New York : Thursday, April 11th 2019 from 07:30am to 09am (GMT-4)
                      Buenos Aires : Thursday, April 11th 2019 from 08:30am to 10am (GMT-3)
                      Reykjavik : Thursday, April 11th 2019 from 11:30am to 01pm (GMT)
                      London / Dublin : Thursday, April 11th 2019 from 12:30pm to 02pm (GMT+1)
                      Paris / Berlin : Thursday, April 11th 2019 from 01:30pm to 03pm (GMT+2)
                      Istanbul : Thursday, April 11th 2019 from 02:30pm to 04pm (GMT+3)
                      Moscou / Dubaï : Thursday, April 11th 2019 from 03:30pm to 05pm (GMT+4)
                      Bangkok : Thursday, April 11th 2019 from 06:30pm to 08pm (GMT+7)
                      Shanghai : Thursday, April 11th 2019 from 07:30pm to 09pm (GMT+8)
                      Tokyo : Thursday, April 11th 2019 from 08:30pm to 10pm (GMT+9)
                      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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