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Key learning & take home
- 2. CTO environment CTO environment CTO mindset Effect on daily routine • more efficacy • more safety • less time Growth mindset
- 3. W Escalation: Gaia Second FineCross Anchor Sapphire 3 0.85x5 mm
- 4. Debulking tools: stenosis crossing or modification? Cutting P-waves Pressure/scoring Sanding/fracturing Photochemical Phototermal Photomecanical When, which, how? Combination?
- 5. Diamondback 360™ Coronary OAS Components •Tortuosity: no > 2 bends > 90° To be avoided •Slow advancement: 1-3 mm/s(the slowest, the larger: up to 1.8 mm) •≤30 s run • rest period (= treatment time; longer if bradicardia/hemodynamic changes) Procedural features: •only large vessels •Only after at least 2 run 80000 rpm •No if < 3mm or tortuosity Speed escalation (120000 rpm): •Tactile feedback: no resistence •Audible pitch: no changes Endpoint: Shlofmitz E. Intervent Cardiol Clin 8 (2019) 161–171 Plaque modification
- 6. Diamondback 360™ Coronary OAS Components •Goal: change plaque morphology and compliance for optimal stent axpansion Only device indicated for severe calcium •Easy/fast setup •Compatible with 6 Fr guide •1:1 Control •Bidirectional •Average particle size 2.04 μm (no slow-flow) •Need for PM? •Need for LV support? Procedural advantages: Shlofmitz E. Intervent Cardiol Clin 8 (2019) 161–171 Ease Safety Efficacy Confidence
Editor's Notes
- First of all there is a general need to support the CTO culture. Working in a cath lab where CTOs are done, attending CTO conferences, looking at expert operators promotes the knowledge of tools and techniques and the develops of a CTO mindset also in non CTO operators, that positively affects our daily routine, making easier complex PCIs, increasing procedural safety and efficacy, and avoiding potentially dangerous waste of time.