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DK crush technique tips and tricks for a better result

EBC - ON DEMAND

European Bifurcation Club 2018 – EBC 2018 – Brussels, Belgium

CASES SESSION: HOW TO PERFORM PCI BY EBC EXPERTS

DK crush technique tips and tricks for a better result

Author: Francesco Lavarra, Jilin Heart Hospital, Changchun

 

CONCLUSION

  • DK CRUSH IS A VALID TECHNIQUE THAT ALLOWS TO TREAT ALSO VERY COMPLEX “2 STENTS” LESIONS, THAT REQUIRES/ALLOWS EXTENSIVE PRETREATMENT OF SIDE BRANCHE LESION. THIS TECHNIQUE IS SUPPORTED BY GOOD BIG DATA FROM LITERATURE AND HUGE MULTIPLES EXPERIENCES
  • CAN BE PERFORMED IN A SIMPLE AND REPRODUCIBLE WAY, ADDING SOME TIPS AND TRICKS TO ADDRESS AND SOLVE DIFFICULTIES AND TO HAVE BETTER ACUTE AND LONG TERM RESULTS (SIDE BRANCH OSTIUM PROBLEMS REDUCED WITH PSO-PROXIMAL SIDE OPTIMIZATION!)
  • PSO (WITH DELIVERY OF SIDE DES AND DILATATION IF IS NEEDED WITH BIGGER HP BALLOON BEFORE THE CRUSH, MOST IF LONGER SIDE BRANCHES AND DIFFERENCE OF DIAMETER FROM PROXIMAL TO DISTAL SIDE BRANCH) IS USEFUL TO OPEN WELL OSTIAL SIDE SEGMENT, FULLY ESPAND THE SIDE STENT, EASIER REWIRING AND KISSING, AVOIDING THE RISK TO GO UNDER THE STRUTS PROXIMALLY, WHEN REWIRING AND KISSING, MOST FOR EXTREMES ANGLES
  • PSO IS NEEDED AT BEGINNING (WHEN SIDE STENTING) AND ALSO HELPED BY I AND II KISSING (WITH SIDE BRANCH BALLOON PROTRUDING MORE IN THE MAIN BRANCH), TO BE DONE WITH SEQUENTIAL SNUGGLE KISSING (HIGH PRESSURE ONLY 1 BALLOON EACH TIME BEFORE KISSING AT 8 ATM, MORE PROXIMAL THAN THE OTHER ONE) TO AVOID THE OVERSTRETCHING AND TOO MUCH ENLARGEMENT OF POLYGON OF CONFLUENCE, BEFORE THE ESSENTIAL FINAL POT
  • SOME MORE BENCH INFORMATIONS (MICRO CT-ORMINSTOGRAPHY) AND SERIES/RANDOMIZED TRIALS ARE NEEDED TO INCLUDE PROXIMAL SIDE OPTIMIZATION TO BECOME ESSENTIAL STEP IN CRUSH AND DK CRUSH INTERVENTIONS

 

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