Discussion around complex PCI

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.