Complex Bifurcation

European Bifurcation Club 2019 - EBC 2019 - Barcelona, Spain ABBOTT SYMPOSIUM OCT for LM and Bifurcation PCI - Case 1:  Complex Bifurcation Author: Tom Johnson, MD, Bristol Heart Institute,…

Imaging in Bifurcation – Parallel Session Summary

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain IMAGING IN BIFURCATION - PARALLEL SESSION SUMMARY Author: Zlatko Mehmedbegovic, MD, Clinical Center of Serbia, Belgrade, Serbia Balloons & stent sizing…

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.

From QFR to OFR: Intracoronary OCT derived FFR for Assessment of Stenosis Severity

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain NEWS 2 From QFR to OFR: Intracoronary OCT-derived FFR for assessment of stenosis severity Author: Shengxian Tu, MD, PhD, Shanghai Jiao Tong University, China Limitations of angiography-based FFR Angiographic image overlap and significant foreshortening Post-PCI optimization: stent mal-apposition/under-expansion OFR Analysis Steps Automatic OCT lumen contour delineation and 3D reconstruction Automatic reconstruction of cut- planes at the side branches ostia Compute OFR using the QFR algorithm SUMMARY OFR (OCT-based FFR) provides lesion morphology and physiological assessment in a single OCT pullback. Compared with FFR, OFR showed good diagnostic accuracy, excellent reproducibility and short analysis time. OFR had substantially better diagnostic accuracy than OCT-MLA. OFR is promising for use in the cath lab for PCI optimization.

Struts across side branch an oct follow up

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain TIPS AND TRICKS IN BIFURCATION PCI - THE SYNERGY BETWEEN EBC AND ASIA Struts across side branch an oct follow up Author: Rony Mathew, MD, DM, Lisie Heart Institute – Lisie Hospital Cochin, India CONCLUSION Struts across a major side branch may be a predictor of side branch re-stenosis.                                                           - Neo-intimal growth over the struts will compromise the side branch ostia over time. Proposed hypothesis:                                                                                                                                                          - Struts across SB on OCT Imaging may be an indication to kiss/PSP, even if the ostia is not compromised on angiography. Follow up OCT study required.

Get Clarity with OCT for LM and Bifurcation PCI Case 1 Complex Bifurcation

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain ABBOTT SYMPOSIUM Get Clarity with OCT for LM and Bifurcation PCI Case 1 Complex Bifurcation Author: Tom Johnson, MD, Bristol Heart Institute, UK CASE SUMMARY Stent failure MANDATES intra-vascular imaging Stent under-expansion common driver but multifactorial Image guidance for plaque modification is critical