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.

Extreme Left Main Stem Calcification

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain AWARD CASE SESSION - VOTING Extreme Left Main Stem Calcification: Rotashock combination therapy Author: Peter O'Kane, MD FRCP, Royal Bournemouth Hospital, UK CLINICAL PRESENTATION 79 year old lady Unstable angina, Troponin 250, eGFR 38 Exertional dysopnea for several months Echo: LVEF 45%with akinetic apex but good regional wall motion elsewhere PCI STRATEGY 7F EBU3.5 Guide RT wire LAD & SB wire LCx Sapphire 2.0x20 balloon not cross LAD •Rotational atherectomy 2 stent technique - culotte of DK Crush • IVUS guided throughout

DK-Culotte: Bench Evaluation

EBC 2019 - Friday 18th October 2019 DK-Culotte: bench evaluation - Benefits of DK-approach during Culotte stenting Author: Gabor G. Toth, MD, PhD, University Heart Centre Graz, Austria

Inverted culotte

European Bifurcation Club 2018 - EBC 2018 - Brussels, Belgium BIFURCATION CLUBS AT EBC: CASE SESSION Inverted culotte Author: Mohamed Zahran, MD, PhD, Ainshams University, Egypt

Problems during Culotte

European Bifurcation Club 2015 - EBC 2015 - Athens, Greece Technique specific problem solving Problems during Culotte Author: Andrejs Erglis, MD, PhD, Latvian Center of Cardiology, Pauls Stradins Clinical University Hospital, Riga, LATVIA

How to perform… Culotte

European Bifurcation Club 2018 - EBC 2018 - Brussels, Belgium CASES SESSION: HOW TO PERFORM PCI BY EBC EXPERTS How to perform… Culotte Author: Dr Tom Johnson, Consultant Cardiologist Honorary Senior…

DK vs. Culotte ~chapter 2~

European Bifurcation Club 2018 - EBC 2018 - Brussels, Belgium BENCH TESTING DK vs. Culotte ~chapter 2~ Author: Yutaka Hikichi, M.D.Ph.D. , Saga University School of Medicine Saga, Japan