EBC - ON DEMAND
Culotte Technique with Endoscopic Visible Heart Imaging and OCT
European Bifurcation Club 2019, EBC 2019 – Barcelona, Spain
MEDTRONIC SYMPOSIUM
– One stent bifurcation techniques and possible bail out solutions using multimodality imaging.
Culotte Technique with Endoscopic Visible Heart Imaging and OCT
Author: Jens Flensted Lassen, MD, PhD, Odense University Hospital, Denmark
SUMMARY OF THE PROCEDURE
1. Implant the first stent.
- Provisional stenting is a philosophy starting with one stent
- The procedure develops stepwise.
- You can stop at any step keeping the procedure as simple as possible (But not too simple)
- Kiss is for positioning of the carina
- Pot is for correcting the proximal Part of the stent
- To ”deep” POT may crush the carina area, but is needed to correct the stent distortion
- KISS with short balloons makes room for a more proximal POT-Balloon placement.
2. Consider the need for a second stent
T, TAP, and Culotte are all just techniques with a second stent and defined only by how deep the stent is placed, according to the side branch ostium.
CONCLUSION
The stepwise progression of the the provisional strategy makes it possible to stop at any stage when the result is satisfying.