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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 : 20544

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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  • 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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                      Monday, September 28th 2020 from 06pm to 07pm (GMT+1)
                      Honolulu : Monday, September 28th 2020 from 07am to 08am (GMT-10)
                      San Francisco : Monday, September 28th 2020 from 10am to 11am (GMT-7)
                      New York : Monday, September 28th 2020 from 01pm to 02pm (GMT-4)
                      Buenos Aires : Monday, September 28th 2020 from 02pm to 03pm (GMT-3)
                      Reykjavik : Monday, September 28th 2020 from 05pm to 06pm (GMT)
                      London / Dublin : Monday, September 28th 2020 from 06pm to 07pm (GMT+1)
                      Paris / Berlin : Monday, September 28th 2020 from 07pm to 08pm (GMT+2)
                      Istanbul : Monday, September 28th 2020 from 08pm to 09pm (GMT+3)
                      Moscou / Dubaï : Monday, September 28th 2020 from 09pm to 10pm (GMT+4)
                      Bangkok : Tuesday, September 29th 2020 from 12am to 01am (GMT+7)
                      Shanghai : Tuesday, September 29th 2020 from 01am to 02am (GMT+8)
                      Tokyo : Tuesday, September 29th 2020 from 02am to 03am (GMT+9)
                      Sydney : Tuesday, September 29th 2020 from 04am to 05am (GMT+11)
                      Wellington : Tuesday, September 29th 2020 from 06am to 07am (GMT+13)

                      What do I do now? Managing Stent Bailout Scenarios during PCI

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                      Thursday, November 15th 2018 from 01pm to 02pm (GMT+1)
                      Honolulu : Thursday, November 15th 2018 from 02am to 03am (GMT-10)
                      San Francisco : Thursday, November 15th 2018 from 04am to 05am (GMT-8)
                      New York : Thursday, November 15th 2018 from 07am to 08am (GMT-5)
                      Buenos Aires : Thursday, November 15th 2018 from 09am to 10am (GMT-3)
                      London / Dublin : Thursday, November 15th 2018 from 12pm to 01pm (GMT)
                      Paris / Berlin : Thursday, November 15th 2018 from 01pm to 02pm (GMT+1)
                      Istanbul : Thursday, November 15th 2018 from 02pm to 03pm (GMT+2)
                      Moscou / Dubaï : Thursday, November 15th 2018 from 04pm to 05pm (GMT+4)
                      Bangkok : Thursday, November 15th 2018 from 07pm to 08pm (GMT+7)
                      Shanghai : Thursday, November 15th 2018 from 08pm to 09pm (GMT+8)
                      Tokyo : Thursday, November 15th 2018 from 09pm to 10pm (GMT+9)
                      Sydney : Thursday, November 15th 2018 from 10pm to 11pm (GMT+10)
                      Wellington : Friday, November 16th 2018 from 12am to 01am (GMT+12)

                      #noGuessPCI in real Bifurcations

                      Enhance your outcomes with OCT and best in class DES

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                      Thursday, January 28th 2021 from 06pm to 07:30pm (GMT+1)
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                      San Francisco : Thursday, January 28th 2021 from 09am to 10:30am (GMT-8)
                      New York : Thursday, January 28th 2021 from 12pm to 01:30pm (GMT-5)
                      Buenos Aires : Thursday, January 28th 2021 from 02pm to 03:30pm (GMT-3)
                      London / Dublin : Thursday, January 28th 2021 from 05pm to 06:30pm (GMT)
                      Paris / Berlin : Thursday, January 28th 2021 from 06pm to 07:30pm (GMT+1)
                      Istanbul : Thursday, January 28th 2021 from 07pm to 08:30pm (GMT+2)
                      Moscou / Dubaï : Thursday, January 28th 2021 from 09pm to 10:30pm (GMT+4)
                      Bangkok : Friday, January 29th 2021 from 12am to 01:30am (GMT+7)
                      Shanghai : Friday, January 29th 2021 from 01am to 02:30am (GMT+8)
                      Tokyo : Friday, January 29th 2021 from 02am to 03:30am (GMT+9)
                      Sydney : Friday, January 29th 2021 from 03am to 04:30am (GMT+10)
                      Wellington : Friday, January 29th 2021 from 05am to 06:30am (GMT+12)

                      Patientenmanagement während einer „Protected PCI“: Wie reduziere ich das periprozedurale Risiko...

                      COMPLEX SKILLS in Protected PCI Series - Course 2

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                      Thursday, February 4th 2021 from 06pm to 07:30pm (GMT+1)
                      Honolulu : Thursday, February 4th 2021 from 07am to 08:30am (GMT-10)
                      San Francisco : Thursday, February 4th 2021 from 09am to 10:30am (GMT-8)
                      New York : Thursday, February 4th 2021 from 12pm to 01:30pm (GMT-5)
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                      Moscou / Dubaï : Thursday, February 4th 2021 from 09pm to 10:30pm (GMT+4)
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                      Wellington : Friday, February 5th 2021 from 05am to 06:30am (GMT+12)

                      Behandlungsstrategien im kardiogenen Schock

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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)
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                      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)

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                      Thursday, March 28th 2019 from 08:40am to 10:30am (GMT+1)
                      Honolulu : Wednesday, March 27th 2019 from 09:40pm to 11:30pm (GMT-10)
                      San Francisco : Wednesday, March 27th 2019 from 11:40pm to 01:30am (GMT-8)
                      New York : Thursday, March 28th 2019 from 02:40am to 04:30am (GMT-5)
                      Buenos Aires : Thursday, March 28th 2019 from 04:40am to 06:30am (GMT-3)
                      London / Dublin : Thursday, March 28th 2019 from 07:40am to 09:30am (GMT)
                      Paris / Berlin : Thursday, March 28th 2019 from 08:40am to 10:30am (GMT+1)
                      Istanbul : Thursday, March 28th 2019 from 09:40am to 11:30am (GMT+2)
                      Moscou / Dubaï : Thursday, March 28th 2019 from 11:40am to 01:30pm (GMT+4)
                      Bangkok : Thursday, March 28th 2019 from 02:40pm to 04:30pm (GMT+7)
                      Shanghai : Thursday, March 28th 2019 from 03:40pm to 05:30pm (GMT+8)
                      Tokyo : Thursday, March 28th 2019 from 04:40pm to 06:30pm (GMT+9)
                      Sydney : Thursday, March 28th 2019 from 05:40pm to 07:30pm (GMT+10)
                      Wellington : Thursday, March 28th 2019 from 07:40pm to 09:30pm (GMT+12)

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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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                      Saturday, June 23rd 2018 from 12am to 04:30pm (GMT+1)
                      Honolulu : Friday, June 22nd 2018 from 01pm to 05:30am (GMT-10)
                      San Francisco : Friday, June 22nd 2018 from 04pm to 08:30am (GMT-7)
                      New York : Friday, June 22nd 2018 from 07pm to 11:30am (GMT-4)
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                      Reykjavik : Friday, June 22nd 2018 from 11pm to 03:30pm (GMT)
                      London / Dublin : Saturday, June 23rd 2018 from 12am to 04:30pm (GMT+1)
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                      Moscou / Dubaï : Saturday, June 23rd 2018 from 03am to 07:30pm (GMT+4)
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                      Shanghai : Saturday, June 23rd 2018 from 07am to 11:30pm (GMT+8)
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                      Sydney : Saturday, June 23rd 2018 from 10am to 02:30am (GMT+11)
                      Wellington : Saturday, June 23rd 2018 from 12pm to 04:30am (GMT+13)

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