Case based tutorial on bifurcation dedicated stent Tryton placement
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The presentation describes step-by-step technic implantation of dedicated bifurcation stent - Tryton.
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Case based tutorial on bifurcation dedicated stent Tryton placement
- 1. Fouladvand F, Holy Family Hospital (Ospedale Sacra Famiglia) Hospitaller Order of St. John of God (Ordine Ospedaliero San Giovanni di Dio) Erba, Italy
- 2. Male 60 y No previous disease • Hypertension • Dyslipidaemia Risk factors Effort angina • Symptoms - angina • V4-V6 - ST Stress test Case presentation • Normal EF • Non hypokinesia • Non valvular alteration Echocardiography • Normal EF • Non hypokinesia Echocardiography
- 3. • Long stenosis Proximal LAD • Medina 1.1.1 LAD/D1 • Radial approach Coronary angiography • HB 3,5 6F • 2 wires BMW Angioplasty • Basal AP-CRANIAL
- 4. • Long stenosis Proximal LAD • Medina 1.1.1 LAD/D1 • RAO-Cranial Basal • Radial approach Coronary angiography • HB 3,5 6F • 2 wires BMW Angioplasty
- 5. • Long stenosis Proximal LAD • Medina 1.1.1 LAD/D1 • AP-Cranial Basal • Radial approach Coronary angiography • HB 3,5 6F • 2 wires BMW Angioplasty
- 6. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • Balloon 2,5 x 30 mm POBA LAD
- 7. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • Balloon 2,5 x 30 mm POBA D1
- 8. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • Ready for Tryton Result post POBA
- 9. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • 3,5/2,5 – 19 mm Advancing Tryton
- 10. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • Carina between 2 mid markers Positioning Tryton
- 11. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • At nominal pressure Releasing Tryton
- 12. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • Acceptable Result after Tryton
- 13. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • NC balloon 3,0 x 15 mm POT PV Tryton
- 14. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • Keep the balloon in Tryton Repositioning wire SB>MB
- 15. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • NC balloon 3,0 x 15 mm POBA LAD
- 16. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • Gently Removing LAD jailed wire
- 17. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • 3,0 x 30 mm DES delivery MB
- 18. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • NC balloon 3,3 x 15 mm POT DES PV
- 19. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • Easily Recrossing MB DES struts
- 20. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • Balloon 2,0 x 15 mm POBA struts DES MB
- 21. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • LAD 2,5 x 30 mm • D1 2,5 x 15 mm Kissing balloon
- 22. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • LAD balloon 2,5 x 30 mm • D1 NC balloon 3,0 x 15 mm Kissing balloon
- 23. Preparation for Tryton Tryton implantation POT Tryton Repositioning wire SB>MB Preparation for DES MB MB DES implantation POT MB DES Recrossing MB DES struts POBA struts DES Kissing balloon Final post-dilatation Strategy • NC balloon 3,5 x 15 mm Post-dilatation DES MB
- 24. Final result
- 25. Final result
- 26. Final result
- 27. Final result