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Introduction

L'équipe de l'HEGP vous donne rendez-vous pour débattre de la stratégie de revascularisation autour de case-in box !

En 1977, A. Grüntzig lance la 1ère révolution du traitement interventionnel de la maladie coronarienne avec l'angioplastie par ballon (plain old balloon angioplasty). Cette POBA présente cependant plusieurs limites : le recoil, la resténose et surtout un risque d'occlusion aiguë par dissection. Et c’est initialement pour traiter cette complication liée à la dissection que va débuter la 2ème révolution de l’angioplastie : l’avènement du stenting, pour traiter en première intention tout type de lésion, chez tout type de patient. Cependant le stenting aura induit une complication propre, la thrombose de stent, augmentant d’autant le risque ischémique du patient.

Le ballon actif, utilisé depuis 2014 pour le traitement de la resténose intrastent, va progressivement s’ouvrir au traitement des lésions de novo, notamment dans les vaisseaux de petit calibre, validé par l’étude BASKET-SMALL 2.Les concepts de « leave nothing behind », de « stentless strategy », font alors leur apparition.
Cette stratégie de revascularisation sans stenting (No Stent Strategy, NSS) peut être privilégiée afin de faciliter la prise en charge pharmacologique de certains patients, ou de simplifier la revascularisation de certaines lésions dites complexes.

Au programme de cette session digitale

  • Introduction
  • Case-in-box 1 : Quand les stents vous compliquent la vie, Un choix discutable
  • Case-in-box 2 : Être actif, mais au ballon !
  • Case-in-box 3 : Après le ballon, savoir rebondir
  • Case-in-box 4 : Avant le tout ballon, passons par l’hybride
  • Back to the future : études en cours
  • Questions et réponses
  • Take home message

Objectifs d'apprentissage

Lors de cette session et à travers des discussions autours de case-in-box l’équipe de l’HEGP aura comme objectif de répondre aux différentes questions :

  • Quelles sont les dernières données sur l’utilisation du ballon actif dans les lésions de novo?
  • Quelles lésions ou quels patients pouvons-nous traiter avec le ballon actif ?
  • Comment bien préparer la lésion dans l’objectif d’utiliser le ballon actif & bien évaluer les résultats angiographiques ?
  • Quels types de dissection faut-il stenter ?

 

Shooting date : 2022-10-06
Last update : 2022-10-07

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