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Synopsis

Three complex coronary interventions have been performed in three different European centers. The three operators are discussing the indication, process, device selection, and quality of results.

Antonio Serra from Spain is presenting a calcified distal right coronary bifurcation treated with Rotablator to facilitate coronary stenting. The technique of rotablation as well as the interest of temporary cardiac pacing is discussed.

Lorenzo Azzalini from Italy is presenting an extremely complex RCA CTO in a post-CABG. The retrograde CTO is performed through an occluded saphenous BG.  Despite the failure of this attempt, several important learning points are openly demonstrated.

Daniel Weilenmann from Switzerland is presenting a three vessels diseased patient with a syntax score of 38, occlusion of CX and RCA, and LAD culprit lesion thrombotic and over diagonal bifurcation. The step procedures and the post procedure management are discussed. 

Moderator: Dr Max Amor
Presenters: Dr Lorenzo Azzalini, Dr Antonio Serra, Dr Daniel Weilenmann

Program

10:30 Case presentation "RCA with massive calcification" - Panel Discussion
Operator: Dr Antonio Serra

 
 
   
10:50 Case presentation "Complex retrograde CTO PCI" - Panel Discussion
Operator: Dr Lorenzo Azzalini
 
 
   
11:10 Case presentation "Complex PCI in Multivessel disease" - Panel Discussion
Operator: Dr Daniel Weilenmann
 
 
   
11:30  Take home messages

Educational objectives

  • Improve coronary angioplasty knowledge (techniques and approach strategies)
  • Discuss the choice of a material
  • How to manage complications
  • Compare techniques and approach strategies of different experts

Audience

  • This web symposium is dedicated to interventional cardiologists interested and/or specialized in coronary angioplasty
  • A prerequisite for attendees is an initial knowledge and practice of angioplasty

Take Home Messages

  • Rotablator is an indespensible device for complex calcified coronary lesions.
  • Old bypass grafts are a way to access to coronary toal occlusion. 
  • Drug coating balloons could be used at the level of bifurcation with a small coronary branch. 
  • Low osmolarity non ionic contrast mediums are safe for these procedures. 
Shooting date : 2017-05-17
Last update : 2017-08-14
Daniel Weilenmann
St. Gallen, Switzerland
Max Amor
Essey-lès-Nancy, France
5 comments
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  • Anil V. For additional support why not use a guideliner?

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    • venkatesa reddy D. very good cases
      thank you for explaining each step

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      • venkatesa reddy D. very good discussion

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        • Max A. Thank you Venkatesa

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          • Shiraz S. Excellent decision making and excellent demonstration of PCI of a complex case. Thank you.

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