Solución caso: A case for CHIPSters
Autor: NEISSER MORALES VICTORINO MD. Director Interventional Cardiology Department – Adolfo Lopez Mateos ISSSTE, México
Moderador: FUNG CHI YAN RAYMOND. Director Interventional Cardiology Department – Princess Margaret Hospital. HongKong.
HOW THE CASE UNFOLDED
-First, Thanks for the comments
-We don’t have option for surgery in this case.
-So, we decide to perform PCI to Culprit Artery.
-The first movement is important for the final result.
TARGET VESSEL: OM
ASSESSMENT
-Culprit Artery.
-OM Acute occlusion
-Glidesheatslender 6/5 Fr
PCI
-XBU 6 Fr
-Pilot 50
-Balloon dilatation
-Recovery Flow TIMI 3.
-Stent or not Stent that’s the question
PCI
Decide the first movement and we have a complication: No reflow… but with recovery after medical treatment.
STOP Take a Deep Breath and live for fight another day…
“Retreat on time is a victory”
So we have 3 bifurcations with different angles, one is LM
CULOTTE TECHNIQUE LAD/1D
DK- CRUSH TECHNIQUE LM/LAD/LCX
Final Comments
Off course maybe is not the best result or the best decision, when you use a lot of stents.
Is the future Drug eluting Balloon?
Always Image First (IVUS, OCT)
Many bifurcations many options of treatment
Until Now DK-Crush is the best strategy for two stents technique in LM.
