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5F TRI IN LMCA

5F TRI IN LMCA. Karam Souibri on behalf of the Interventional cardiology department University Hospital of Caen, France. INTRODUCTION 5F TRI is safe and feasible for PCI and direct stenting. Need for large diameter stents, low back-up… can be considered as severe limitations

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5F TRI IN LMCA

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  1. 5F TRI IN LMCA Karam Souibrion behalf of the Interventional cardiology departmentUniversity Hospital of Caen, France • INTRODUCTION 5F TRI is safe and feasible for PCI and direct stenting. • Need for large diameter stents, low back-up… can be considered as severe limitations • In routine practice some tip and tricks can help to overcome these limitations Case report • Non ST ACS 67 year-old dyslipidemic patient • Treated with GpIIb/IIIa inhibitors • 5F JL4 guiding catheter (Launcher form Medtronic) • Revealing ulcerous stenosis in a 5mm caliber LMCA and 2 other

  2. 5F TRI IN LMCA • What to do ? • CABG? • PCI? - switch to femoral? - switch to 6F? 7F? - direct stenting? - drug eluting stent?

  3. 5F TRI IN LMCA • Maintained guiding 5F JL4 • Direct LMCA stenting (Express 5mmx16mm) • Difficulties to progress the following stents in LAD - Stop procedure? -Switch 6F? - Any other trick?

  4. 5F TRI IN LMCA Buddy wire technique for stent placement • Buddy Wire (parallel wire) (Choice guidewires 0.014 ’’) • Successfull stent placement and deployement in the 2 LAD stenosis (Motion MV3.5x13mm and 3x13mm)

  5. 5F TRI IN LMCA • PCI using 5F Radial access can routinely be performed • 5mm stents in selected cases Can be considered • Deep catheter intubation is frequently required for direct stenting • Buddy wire technique avoids switching to larger catheters

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