This document discusses techniques for chronic total occlusion (CTO) recanalization. It describes analysis of data from the UK Central Cardiac Audit Database on over 13,000 patients who underwent elective CTO percutaneous coronary intervention (PCI) between 2005-2009. The document reports that successful revascularization is associated with reduced mortality. It also provides an overview of the CTO PCI timeline and techniques that have been developed for CTO recanalization, including wires, microcatheters, intravascular ultrasound (IVUS), and balloons.
Microcatheters for antegrade and retrograde approachEuro CTO Club
Microcatheters for antegrade and retrograde approach
George Sianos, Thessaloniki, Greece
11th Experts Live CTO
The annual Euro CTO meeting
September 13th –14th, 2019 - Berlin, Germany
Microcatheters for antegrade and retrograde approachEuro CTO Club
Microcatheters for antegrade and retrograde approach
George Sianos, Thessaloniki, Greece
11th Experts Live CTO
The annual Euro CTO meeting
September 13th –14th, 2019 - Berlin, Germany
Foreign body removal during cardiac catheterizationRamachandra Barik
The removal of foreign bodies from the heart and vasculature has shifted from the domain of the radiologist and even the thoracic or vascular surgeon to the terventional cardiologist and, in turn, from the radiographic suite or operating room to the cardiac catheterization Laboratory.
SAN FRANCISCO—Results from ORBIT II, a clinical trial designed to evaluate the safety and efficacy of the Diamondback 360° Orbital Atherectomy System to treat de novo severely calcified coronary lesions, were presented March 9 at the American College of Cardiology (ACC) scientific session.
Use of adjunct devices like cutting balloon, rotaablation, excimer laser,mechanical thrombectomy and EPD in complex PCI improve procedural success and reduce restenosis rate.
Optimize guide catheter support
Fabrice Leroy, Lille, France
11th Experts Live CTO
The annual Euro CTO meeting
September 13th –14th, 2019 - Berlin, Germany
rotablation is procedure used in complex pci with heavily calcified lesion for adequate expansion of stent.if used in indicated case and well aware of contraindication is necessary for achieving good results.
Foreign body removal during cardiac catheterizationRamachandra Barik
The removal of foreign bodies from the heart and vasculature has shifted from the domain of the radiologist and even the thoracic or vascular surgeon to the terventional cardiologist and, in turn, from the radiographic suite or operating room to the cardiac catheterization Laboratory.
SAN FRANCISCO—Results from ORBIT II, a clinical trial designed to evaluate the safety and efficacy of the Diamondback 360° Orbital Atherectomy System to treat de novo severely calcified coronary lesions, were presented March 9 at the American College of Cardiology (ACC) scientific session.
Use of adjunct devices like cutting balloon, rotaablation, excimer laser,mechanical thrombectomy and EPD in complex PCI improve procedural success and reduce restenosis rate.
Optimize guide catheter support
Fabrice Leroy, Lille, France
11th Experts Live CTO
The annual Euro CTO meeting
September 13th –14th, 2019 - Berlin, Germany
rotablation is procedure used in complex pci with heavily calcified lesion for adequate expansion of stent.if used in indicated case and well aware of contraindication is necessary for achieving good results.
The knowledge of variety of chronic total occlusion (CTO) hardware and the ability to use them represents the key to success of any CTO interventions. However, the multiplicity of CTO hardware and their physical character and the terminology used by experts create confusion in the mind of an average interventional cardiologist, particularly a beginner in this field. This knowledge is available but is scattered. We aim to classify and compare the currently used devices based on their properties focusing on how physical character of each device can be utilized in a specific situation, thus clarifying and simplifying the technical discourse
This presentation provides sufficient material for anyone who wants is interested in interventional radiology. Here we will discuss the available facilities, mechanisms and equipments.
In my opinion this presentation will prove a footstep in interventional radiology
Jogler is a Baton Rouge, Louisiana manufacturer of high quality Magnetic Level Gauges, Magnetostrictive Transmitters, Direct-Reading Level Gauges with armored shield, Sight Flow Indicators, Specific Gravity Analyzers, Point Level Switches and other accessories.
The ILT-6000 contains a low profile waveguide that is inserted into a waveguide sleeve isolation well and float assembly. The waveguide sleeve isolates the internal waveguide from the process environment and protects it from excessive process conditions. This provides an additional safety barrier for the operator. The major benefit is the transmitter and waveguide can be removed for field checking without interruption or exposure to the process environment
BALTON Ltd. is the producer of of medical equipment for ANAESTHESIOLOGY, DIALYSIS, SURGERY, CARDIOLOGY, RADIOLOGY, UROLOGY, GYNECOLOGY.
One of the most important achievements of the company is the production of stents for coronary and peripheral vessels as well as self-expanding stents.
Nowadays Balton company sells its products to more than 60 countries in the world.
OPTISWITCH 4000/5000 series operates using a vibrating fork to reliably detect the level of liquids independently of adhesion on the fork, container vibrations or changing product properties. Thanks to the high reproducibility of the switching point and the integrated function monitoring, the OPTISWITCH can be used for high and low level alarms, overfill protection, dry-run detection or pump control in virtually every liquid application.
15th Experts Live CTO - Carlo Di Mario: ConclusionsEuro CTO Club
PLENARY SESSION
Wrap up of live cases, awards to the winners of the best abstracts and case competitions and take home messages
Auditorium Zubin Mehta - Saturday 16:00 - 17:00
Speakers:
Daniela Benedetto (Rome),
Francesco Burzotta (Rome),
Carlo Di Mario (Florence),
Roberto Garbo (Turin),
Rocco Stio (Rome)
Challengers:
Stelios Pyxaras (Furth - D),
Sudhir Rathore (London - UK)
Discussants:
Shunsuke Matsuno (Tokyo - J),
Alexander Nap (Amsterdam - NL),
Masahisa Yamane (Tokyo - J)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Francesco Burzotta: Wrap up Gemelli CasesEuro CTO Club
PLENARY SESSION
Wrap up of live cases, awards to the winners of the best abstracts and case competitions and take home messages
Auditorium Zubin Mehta - Saturday 16:00 - 17:00
Speakers:
Daniela Benedetto (Rome),
Francesco Burzotta (Rome),
Carlo Di Mario (Florence),
Roberto Garbo (Turin),
Rocco Stio (Rome)
Challengers:
Stelios Pyxaras (Furth - D),
Sudhir Rathore (London - UK)
Discussants:
Shunsuke Matsuno (Tokyo - J),
Alexander Nap (Amsterdam - NL),
Masahisa Yamane (Tokyo - J)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Jonathan Hill: Role of mechanica support in CTO recanalizationEuro CTO Club
10:42
Role of mechanica support in CTO recanalization
Jonathan Hill (London - UK)
___________________________________________
PARALLEL SESSION
Challenges And Opportunities In Cto Recanalization
Auditorium Zubin Mehta - Saturday 10:00 - 11:10
Chairperson:
Jonathan Hill (London - UK)
Discussants:
Lesnek Bryniarski (Krakow - PL),
Ugo Fabrizio (Vercelli),
Paul Knaapen (Amsterdam - NL),
Eugenio La Scala (Ollioiouls - F)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Gregor Leibundgut: Role of DEB in CTO-PCIEuro CTO Club
10:35 Role of DEB in CTO-PCI
Gregor Leibundgut (Basel - CH)
___________________________________________
PARALLEL SESSION
Challenges And Opportunities In Cto Recanalization
Auditorium Zubin Mehta - Saturday 10:00 - 11:10
Chairperson:
Jonathan Hill (London - UK)
Discussants:
Lesnek Bryniarski (Krakow - PL),
Ugo Fabrizio (Vercelli),
Paul Knaapen (Amsterdam - NL),
Eugenio La Scala (Ollioiouls - F)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Kambis Mashayekhi: EuroCTO Consensus on treatment of Calcified CTO lesion Eur...Euro CTO Club
AUDITORIUM ZUBIN MEHTA
08/09/2023 04:30 - 05:20
PLENARY SESSION - INTERVENTIONAL CTO & CHIP RESEARCH Best CTO Publications 2022-23 (selected by the Editors of the Cardiology Interventional journals)
Emmanouil S. Brilakis - CTO PCI Outcome associated with poor quality of the d...Euro CTO Club
16:53
CTO PCI Outcome associated with poor quality of the distal target vessel
Emmanouil Brilakis (Minneapolis - USA)
_____________________________________________
PARALLEL SESSION
Interventional CTO & Chip Research
Best CTO Publications 2022-23 (selected by the Editors of the Cardiology Interventional journals)
Auditorium Zubin Mehta - Friday 16:30 - 17:16
Chairpersons:
Davide Capodanno (Catania),
Carlo Di Mario (Florence),
Giuseppe Tarantini (Padua)
Panelist:
Roberto Diletti (Rotterdam - NL),
Giovanni Esposito (Naples),
Paul Knaapen (Amsterdam - NL),
Maksymilian Opolski (Warsaw - PL)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Mario Iannaccone - 2 EuroCTO Consensus on Guide Catheter Extensions JACC Card...Euro CTO Club
16:33
EuroCTO Consensus on Guide Catheter Extensions JACC Cardiovasc Interventions
Mario Iannaccone (Turin)
_____________________________________________
PARALLEL SESSION
Interventional CTO & Chip Research
Best CTO Publications 2022-23 (selected by the Editors of the Cardiology Interventional journals)
Auditorium Zubin Mehta - Friday 16:30 - 17:16
Chairpersons:
Davide Capodanno (Catania),
Carlo Di Mario (Florence),
Giuseppe Tarantini (Padua)
Panelist:
Roberto Diletti (Rotterdam - NL),
Giovanni Esposito (Naples),
Paul Knaapen (Amsterdam - NL),
Maksymilian Opolski (Warsaw - PL)
___________________________________________
15th Experts Live CTO,
EUROCTO Club meeting in partnership with the GISE CTO meeting.
September 8th - 9th, 2023
Florence, Italy
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
10:05 Gershlick - The kit
1. Department Academic Cardiology
Tony Gershlick
Professor of Interventional Cardiology
University Hospitals of Leicester UK
Madrid 2014
Chronic Total Occlusions :
The kit
National Institute for Health Research,
Leicester Cardiovascular Biomedical
Research Unit
2. Methods
• Analysis of the UK Central Cardiac Audit
Database
• Procedures between Jan 1st 2005 – Dec 31st
2009
• 326 398 PCI procedures
• 15 492 elective CTO procedures on 13 443
patients
• Mortality data from the Medical Research
Information Service (MRIS)
5. Pandora's box is an artifact in Greek mythology, taken from the myth of
Pandora's creation in Hesiod's Works and Days.
The "box" contained all the evils of the world.
Impelled by her curiosity (given to her by the gods ), Pandora opened it
and all evil contained therein escaped and spread over the earth. She
hastened to close the container, but the whole contents had escaped;
22. - Beyond Fielder XT -
• Anti kinking structure
• Higher torque performance with W core
Tip load
XT-A = 1.0g XT-R = 0.6g
23.
24.
25.
26. PTFE Coat
・ Length over all ; 1900
・Coil length ; 160
・Radio paque ; 160
Unit ; (mm)
straigh
t
taper
3010
0.014Inch
Urethan + Hydrophilic Polymer
Coat
0.009Inch
Fielder XT
27. • Uni-body core with long, smooth taper from support
region to tip
• Hydrophilic-coated, polymer sleeve and tip
• Intermediate wire with slightly stiffer tip
• Crossing performance of polymer tip with visibility of
spring tip
PT Graphix™ Guide Wire
30. 0.014“
Hydrophilic Coating
17cm Radiopaque Spring Coil
0.008“
Stainless Steel Core PTFE Coating
0.014“
Confianza Pro 8-20
Tip Load: 20G
Radiopacity length: 17cm
Outside Diameter: 0.014inch
Tip outside Diameter: 0.008inch
*Product not available in Europe
31. Micro cone. enables easy creation of
an entry route into hard fibrous cap.
almost needle like. The tip loads are
low, 1.7 on the first, 3.5 on the second
and 4.5 on the third but have the
penetrative power of the higher tip
miracles.
Gaia also is part of the new Sion Tecc
range so has 1 - 1 torque
The shaft thickness are different from
1 st through to 3 rd and the tapers and
tip diameter differ on each wire.
The Gaia allows you to steer your way
through a CTO using rotational
deflection, you can change your
direction if you get stuck and try a
different path, the wire is designed to
stay in the true lumen.
34. TEIS
Improve wire pushabilityConcentrate rotating force
for better wire control
Superior device passage for the next option
1. 2.
Clinical benefits of Finecross® MG
3.
37. ewire Crossing – Unique features demonstration
1. NHancer CTO access
The presence of micro channels has proven to be a
significant factor of CTO crossing success. If these are
tip to tip > 1 (cm)
tip to tip ̴ 4 (mm)
tip to tip ̴ 2 (mm)
sis demonstrate that
O closure are more to
l than to the vessel
ry would be ideal
ssel perforation/
men
lization of micro
lcification on the route
aping analysis of CTO
ically a wire take-off
vessel diameter at
l guidewire tip
at vessel wall area.
p take –off (2.5 mm)
All illustrations are on scale. Vessel is 2.5 (mm)
p take –off (2.3 mm)
NHancer enables on angio tip shaping
which increase the ability to seek CTO
entry more to the center of the CTO
– Revolutionize Primary Guidewire Cross
2. Adaptive force transmission
Conventional support catheters back-out
when backup support is needed
Due to the unique locking feature the
NHancer cannot back out and provides
more support to the guidewire tip.
The improved force transmission
increases the capability of the wire to
penetrate and cross the CTO.
Escalating wire selection towards stiffer
tip configurations, higher tip load, is
3. Smallest shaft profile
The NHancer’s small shaft
profile, combined with the
NDurance hydrophilic
coating reduces the need
to dilate vulnerable septals
and eases septal crossing
during retrograde
approach
38.
39. Specialty Catheter designed for guide wire support and exchange
The Tornus specialty catheter, with its braided stainless steel
construction, is designed to enable guide wire exchange and support.
Braided Stainless Steel Catheter
for outstanding support and pushability
1mm Distal Radiopaque Marker
for easy visualization of the distal tip
Tapered Tip
designed to facilitate access to challenging lesions
Asahi Tornus ®
48. C7 Dragonfly™ Intravascular Imaging
Catheter
•Non-occlusive flush action
eliminates the need for
occlusion balloon
•Extreme Resolution imaging
based on OCT technology
•Low-profile minirail tip for fast
placement
•Hydrophilic coating reduces
drag
•Dual marker bands for precise
positioning
•Compatible with standard
0.014” steerable guidewires
•Imaging speed up to 25 mm
51. Tracks via FAST SPIN technique
•Spin should reduce push required
•Highly torqueable shaft
0.014" guidewire
compatible (OTW)
Atraumatic 3F
rounded distal tip
2.3F shaft profile
The CrossBoss™ CTO Catheter
52.
53. Balloons: Falcon CTO Balloon RX/OTW 1.00mm
Falcon CTO is a small diameter 1.00mm designed for
Chronic Total Occlusions.
Technological Innovations
Low entry profile (0.016”) facilitates lesion
access
Tapered 4.5mm tip crosses the lesion first
Up to 15 atm RBP and a variety of lengths offer
many treatment options
Proprietary Shaft
Shaft maintains efficient transmission of push
Tack-welded inner tube enhances trackability
and pushability
4.5-mm Elongated Tip
Tapered tip navigates tortuous anatomy
Flexible design enhances steerability
Low-entry profile tip (0.016”) provides excellent tip-to-wire transition
4.5-mm tip crosses the lesion prior to balloon
1.35 mm at 15 atm provides access for a wide range of treatment options
No accordion effects while
crossing and recrossing
arteries
Test data on file at Medtronic Inc. Bench test results may not be indicative of clinical results
Crossing Semi-Compliant
54. Falcon CTO is a small diameter 1.00mm designed
for Chronic Total Occlusions.
Product Specifications
Catheter design: RX OTW
Balloon material: Flexitec PF
Balloon coating: LFC hydrophilic coating
Balloon marker: 1 or 2 swaged (zero profile)
platinum iridium
Shaft diameter: OTW: distal 2.2 F; proximal 3.3 F
RX: distal 2.2 F; proximal 2.0 F
Usable shaft length: 145 cm and 160 cm
Maximum
recommended
guidewire: 0.014” (0.36 mm)
Low-entry profile tip (0.016”) provides excellent tip-to-wire transition
4.5-mm tip crosses the lesion prior to balloon
1.35 mm at 15 atm provides access for a wide range of treatment options
DCR
this
slide
Balloons: Falcon CTO Balloon RX/OTW 1.00mmCrossing
68. Can knowing (and being expert with )
the available kit make a difference ?
69. • Observational study
• 483 participants with CTO
• Selection of patients based on symptomatic angina, evidence
of viability and ischaemia in CTO territory (CMR, MPS, exercise
stress echo)
• Classification of lesion complexity using J-CTO score
• Success determined within 2 time periods:
- Period 1: April 2003 – October 2008
- Period 2: October 2008 – May 2012
Sysreloudis D et al. Heart 2013; 99: 474-479
70. Technique Period 1 Period 2
Corsair microcatheter for antegrade/retrograde
support
No Yes
7F guiding cathtetrs allowing trapping balloon use No Yes
Reverse CART and wire escalation, retrograde
knuckled wire for controlled subintimal dissection
No Yes
7-8Fr Antegrade catheters Rare Routine
Anchoring balloon Rare Routine
Long femoral sheath Rare Frequent
Contralateral injection Routine Routine
Parallel wire technique Frequent Frequent
Stingray Catheter for distal re-entry No Rare (bail-out if
no retrograde
option present)
Wire “sliding “ with tapered soft wire Rare Routine as start
of an antegrade
approach
Sysreloudis D et al. Heart 2013; 99: 474-479
73. Success rates by procedural complexity
Sysreloudis D et al. Heart 2013; 99: 474-479
74. Keep it simple if possible
Become familiar with particular kit and use frequently
Be aware of device options
Don’t get carried away
A series of escalating wires
IVUS
Micro-catheter /Corsaire
Guideliner/Guidezilla
