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IVUS Guided Wiring in CTO PCI. Hakujikai Memorial Hospital Yasushi Asakura M.D. Step by Step Approach. Antegrade Approach with Single Wire. ↓. Parallel Wire Technique. ↓. Retrograde Approach. ↓. IVUS Guided Wiring. Step by Step Approach. Antegrade Approach with Single Wire.
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IVUS Guided Wiring in CTO PCI Hakujikai Memorial Hospital Yasushi Asakura M.D.
Step by Step Approach Antegrade Approachwith Single Wire ↓ Parallel Wire Technique ↓ Retrograde Approach ↓ IVUS Guided Wiring Hakujikai Memorial Hospital
Step by Step Approach Antegrade Approachwith Single Wire Antegrade Approachwith Single Wire ↓ Parallel Wire Technique ↓ Retrograde Approach ↓ IVUS Guided Wiring Hakujikai Memorial Hospital
Case Hakujikai Memorial Hospital
IVUS Guided Wiring Hakujikai Memorial Hospital
IVUS Hakujikai Memorial Hospital
Final Hakujikai Memorial Hospital
Step by Step Approach Antegrade Approachwith Single Wire ↓ Parallel Wire Technique ↓ Retrograde Approach Retrograde Approach ↓ IVUS Guided Wiring Hakujikai Memorial Hospital
IVUS Findings Hakujikai Memorial Hospital
Step by Step Approach Antegrade Approachwith Single Wire ↓ Parallel Wire Technique ↓ Retrograde Approach ↓ IVUS Guided Wiring IVUS Guided Wiring Hakujikai Memorial Hospital
Case Hakujikai Memorial Hospital
Retrograde Approach ↓ Failure Hakujikai Memorial Hospital
IVUS Guided Wiring Hakujikai Memorial Hospital
Successful Wiring Confienza Pro 8-20 Hakujikai Memorial Hospital
IVUS Hakujikai Memorial Hospital
Final Hakujikai Memorial Hospital
Where should the 2nd wire run? Re-EntryX Fresh StartO Hakujikai Memorial Hospital
Case Hakujikai Memorial Hospital
RAO view Hakujikai Memorial Hospital
Identify a CTO entry by IVUS 2nd Wire RV branch 2nd Wire RV branch IVUS IVUS Hakujikai Memorial Hospital
Failure to cross 2ndWire True lumen Hakujikai Memorial Hospital
Parallel Wire Technique Hakujikai Memorial Hospital
Retrograde Approach Hakujikai Memorial Hospital
IVUS Guided Wiring LAO RV branch Toyohashi Heart Center Hakujikai Memorial Hospital
Final Hakujikai Memorial Hospital
3 Dimensional Orientation RAO LAO IVUS Left 2nd Wire Right RAO View LAO View Hakujikai Memorial Hospital
Case RotationalAngiography Hakujikai Memorial Hospital
RAO 20 LAO 70 LAO RAO GW IVUS Hakujikai Memorial Hospital
CTO RAO Intima RAO IVUS GW Hakujikai Memorial Hospital
Navi Focus GW Transducer Tip ~ Sensor Hakujikai Memorial Hospital
LAO 40 RAO 50 Overlap GW Left IVUS Right Hakujikai Memorial Hospital
Navi Focus LAO 40 RAO 50 IVUS GW Hakujikai Memorial Hospital
Summary 1. In an antegrade approach, IVUS is used in order to identify the entry. 2. IVUS is helpful for reverse CART in retrograde approach. 3. IVUS guided wiring is the last resort in CTO PCI. 4. The 2nd wire should go through within intima from begin to end. 5. Three dimensional recognition is important in this strategy. Hakujikai Memorial Hospital
TOPIC 2017 July 20-22, 2017 Thank You for Attention! Toyohashi Heart Center
Treating CTO Lesions with Imaging Guidance Hakujikai Memorial Hospital Yasushi Asakura M.D.
Disclosure Statement of Financial Interest I, Yasushi Asakura DO NOT have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this presentation. Hakujikai Memorial Hospital
Trajectory should be in the intima! Hakujikai Memorial Hospital
