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.