1 / 34

Using a deflectable tipped Catheter to treat previously inaccessible lesions

Using a deflectable tipped Catheter to treat previously inaccessible lesions. Helen Routledge Interventional Fellow Institut Cardiovasculaire Paris Sud SpR Cardiology, University Hospital Birmingham. Multiple PCI procedures LCA. Failed PCI to CTO RCA

adlai
Download Presentation

Using a deflectable tipped Catheter to treat previously inaccessible lesions

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Using a deflectable tipped Catheter to treat previously inaccessible lesions Helen Routledge Interventional Fellow Institut Cardiovasculaire Paris Sud SpR Cardiology, University Hospital Birmingham

  2. Multiple PCI procedures LCA. Failed PCI to CTO RCA CABG Feb 2006 - RIMA to proximal PDA + SVG to distal RCA May 2006 - Unstable angina Lesion at ostium of PLA 51 year old male Occluded SVG to RCA Patent RIMA to PDA

  3. 1st Attempt at PCI : Guiding Catheter dissection ostium of RIMA Recurrent Angina CCS 3 in Nov 06 Treated for ISR in LCA and DES in proximal RIMA Recurrent angina

  4. IntractableAngina Extreme angulation Lesion tortuosity Access 6f RRA, IMA Minimal support

  5. BMW (Guidant Corp.) PT2 (Boston Scientific) Whisper (Guidant Corp.) Cross-it (Terumo) Steer-It (Cordis) Impossible to Wire?

  6. Re-do bypass grafting Medical therapy Try and get round the bend…..! Venture Catheter Solutions?

  7. Venture TM Catheter Over the wire or Monorail low profile, 3.5F catheter Steerable radiopaque tip

  8. Whisper advanced into PLA Venture catheter advanced over Whisper

  9. Whisper exchanged for BHW (Guidant Corp.) Venture Catheter advanced further into PLA

  10. Predilatation, Cypher 2.5 x 18mm Stent, Wire Exchange, Kissing

  11. Final result – free of Angina

  12. SVG to LCx

  13. SVG to LCx Cypher 2.5 x 13mm Venture BHW guidewire

  14. SVG to PDA Venture Catheter deflected towards PLA Lesion compromising large PLA

  15. Unable to stent Buddy wire Endeavour Pre-dilated

  16. Post-dilated, final result

  17. Difficult Side Branch Access Before and after Main Branch Stenting

  18. 62 year old female - ACS

  19. Failure to Wire SB BMW (Boston Scientific) Whisper (Guidant Corp.) Choice PT(Terumo) Venture Monorail + BMW

  20. PTS strategy Taxus 3 x 20 12 ATM

  21. PTS strategy Taxus 3 x 20 12 ATM

  22. Final Kissing, Final Result

  23. Failure to Re-wire SB

  24. Subocclusion, Occlusion

  25. Venture Monorail, kissing

  26. Result

  27. Side Branch Access - Trifurcation

  28. Side Branch Access - Trifurcation Difficult to wire Septal.. Venture and Whisper

  29. Angulation & Tortuous Anatomy Difficult side branches

  30. LMS PCI – recrossing to LCx

  31. Side Branch Access - Trifurcation MB Stent Pre-dilatation septal

  32. Side Branch Access - Trifurcation

  33. SVG to LAD Tortuosity, double bend, angulation Venture?

  34. Angulated and tortuous lesions beyond Grafts 4 Retrograde? Wire advanced to native vessel

More Related