nicolas boudou - retrogradecto pci in leftdominant coronaryartery
TRANSCRIPT
Retrograde CTO PCI in leftdominant coronary arteryRetrograde CTO PCI in leftdominant coronary artery
Nicolas Boudou, MD,
Cardiology department
Rangueil university hospital
Toulouse, France
Pôle Cardiovasculaire et Métabolique
Pôle Cardiovasculaire et Métabolique
Potential conflicts of interest
Speaker's name: Dr Nicolas Boudou
I do not have any potential conflict of interest
LAD occlusion and collaterals
Conus artery
Guide catheter extension for ping pongtechnique
Monorail, rapid exchange:
- Guidezilla®, Boston SC 5F dans 6F- Guidion®, IMDS…
Guideliner®, Vascular Solutions 5F dans 6F
• Coaxial, over the wire:
5F in 6F, 120 cm
Heartrail II®, Terumo
Guide catheter extension for ping pongtechnique
Ping Pong technique: 2 guiding catheters in the same coronary artery
Brilakis ES, Grantham JA, Banerjee S. “Ping-pong” guide catheter technique for retrogradeintervention of a chronic total occlusion through an ipsilateral collateral.
Catheter Cardiovasc Interv 2011;78:3959.
• Retrograde approach through a septal colllateral• Guide catheter extension in LCx to protect the left main• Pure retrograde wire crossing and wiring in the Guide cath extension
Ping Pong technique: 2 guiding catheters in the Left coronary artery
CTO in ostial LAD
• Previous failure in another institution with dissection and haematoma of the proximal LAD
• Retrograde approach through septal from LCx
Retro CART with Guide extension
FU @ 3 months
Key points
• Retrograde in same coronary artery: left dominant
artery
• Septal or epicardial collateral
• Ping Pong technique
• Guide catheter extension
– To protect a branch not diseased
– To secure retrograde crossing