Imaging in Bifurcation – Parallel Session Summary

Imaging in Bifurcation – Parallel Session Summary

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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 for bifurcation PCI: role of IC imaging  – Y. Murasato

TAKE HOME MESSAGES:

  • Device sizing (general):
    EEL-based reference diameter measurement is firstly recommended (lumen based 2nd option). • Device sizing: bifurcation lesion
  • POT and KBI balloon should be selected according to vascular branching law (IMAGING derived references!)
  • Minimum expansion index – select post-dilation site and appropriate balloon.

Plaque characteristics in bifurcation lesion: Efficient strategy making by IC imaging  – N. Gonzalo

TAKE HOME MESSAGES

  • Intracoronary imaging is useful to determine the plaque composition and confirm an adequate plaque preparation.
  • Information regarding plaque distribution, calcium location and vessel size can be used to select the bifurcation stenting technique

Imaging-guided rewiring in bifurcation : 2D and 3D OCT  – R. Nagoshi 

OPTIMUM (A randomized trial evaluating On-line three-dimensional OFDI guided PCI vs. angiography guided PCI in bifurcation lesions)  – Y. Onuma 

Impact of bifurcation angle on incomplete stent apposition  – M. Yamawaki

Algorithm: When to perform imaging to optimize efficiency (OCT)  –  T. Okamura

Tips and Tricks: Ostial marking

  • Additional GW is positioned in Aorta to avoid cannulation of the guide catheter beyond ostium.
  • Use co-registration of OCT and angiography
  • Slow pullback (ex 10mm/s for OFDI, HD mode for Optis) would be recommended.
  • Contrast injection starts at more than 4ml/s of flush rate, when the optical lens approaches.

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