×
It looks like you're using an obsolete version of internet explorer. Internet explorer is no longer supported by Microsoft since the end of 2015. We invite you to use a newer browser such as Firefox, Google Chrome or Microsoft Edge.
My Player placeholder

Become an Incathlab member and receive full access to its content!

You must be an Incathlab member to access videos without any restrictions. Register for free in one minute and access all services provided by Incathlab.You will also be able to log into Incathlab from your Facebook or twitter account by clicking on login on the top-right corner of Incathlab website.

Registration Login


16545 views

Case summary

Patient: male 77 y

Dyspnea and angina since several months

NSTEMI 26.11.16

3 vessels disease:  several stenosis LAD, CX and RCA

 culprit lesion LAD (with thrombus)

CTO IM branch und PD of RCA

Syntax score:  28

LVEF:      45%

Inferior and apikal akinesia

No valvular heart disease

Renal function:  eGFR = 85 ml/min/1.73m2

CVRF:  aHT, dysplidemia

How to treat this patient?

Syntax score: 28

EuroSCORE II:  2.2

STS-score:  1.2 for mortality

    9.4 for morbiditiy and mortality

Proposed treatment:   CABG, but patient refused

Todays planned procedures:

PCI of the LAD and diagonal branch

Ev. RCX PCI

Protocol

OptiRAY® (Ioversol)

Concentration 300 mgI/mL

Flow rate: 3.5 mL/ s

Volume: 112 mL

Total exposure : 0.8 Gy

Exposure time: 27 minutes

15 images / s low dose Philips

57 images mostly fluoro

 

Shooting date : 2016-11-03
Last update : 2021-06-09
Daniel Weilenmann
St. Gallen, Switzerland

OptiRAY® / Guerbet

Optiray® contrast agent is lower osmolar, lower viscosity and nonionic.
2 comments
Join the Discussion
  • Alexander P. Why DES in distal LAD ? BVS Absorb?

    • Daniel W. Hi Alexander. Thank you for your question. We know from the Absorb data that scaffolds perform worse than DES in smaller vessels, associated with a higher MACE rate. An alternative could be treating small vessels with DCB. The BASKET small study result will be presented in 2018 (DES vs DCB in small vessels). DCB are good in our experience when you have TIMI flow III, no more than a dissection A or B, and less than 30% residual stenosis.

    Please, select your files, click upload button, write your comment and click the send button. (allowed formats : images jpeg, gif, png, and PDF)
    Your browser doesn't have Flash, Silverlight or HTML5 support.


Suggestions

Tuesday, June 21st 2022 from 06pm to 07pm (GMT+2)
Honolulu : Tuesday, June 21st 2022 from 07am to 08am (GMT+2)
San Francisco : Tuesday, June 21st 2022 from 10am to 11am (GMT+2)
New York : Tuesday, June 21st 2022 from 01pm to 02pm (GMT+2)
Buenos Aires : Tuesday, June 21st 2022 from 02pm to 03pm (GMT+2)
Reykjavik : Tuesday, June 21st 2022 from 05pm to 06pm (GMT+2)
London / Dublin : Tuesday, June 21st 2022 from 06pm to 07pm (GMT+2)
Paris / Berlin : Tuesday, June 21st 2022 from 07pm to 08pm (GMT+2)
Istanbul : Tuesday, June 21st 2022 from 08pm to 09pm (GMT+2)
Moscou / Dubaï : Tuesday, June 21st 2022 from 09pm to 10pm (GMT+2)
Bangkok : Wednesday, June 22nd 2022 from 12am to 01am (GMT+2)
Shanghai : Wednesday, June 22nd 2022 from 01am to 02am (GMT+2)
Tokyo : Wednesday, June 22nd 2022 from 02am to 03am (GMT+2)
Sydney : Wednesday, June 22nd 2022 from 04am to 05am (GMT+2)
Wellington : Wednesday, June 22nd 2022 from 06am to 07am (GMT+2)

Distal & Conventional: what will be the future of radial access?

Share
Thursday, June 23rd 2022 from 05pm to 06pm (GMT+2)
Honolulu : Thursday, June 23rd 2022 from 06am to 07am (GMT+2)
San Francisco : Thursday, June 23rd 2022 from 09am to 10am (GMT+2)
New York : Thursday, June 23rd 2022 from 12pm to 01pm (GMT+2)
Buenos Aires : Thursday, June 23rd 2022 from 01pm to 02pm (GMT+2)
Reykjavik : Thursday, June 23rd 2022 from 04pm to 05pm (GMT+2)
London / Dublin : Thursday, June 23rd 2022 from 05pm to 06pm (GMT+2)
Paris / Berlin : Thursday, June 23rd 2022 from 06pm to 07pm (GMT+2)
Istanbul : Thursday, June 23rd 2022 from 07pm to 08pm (GMT+2)
Moscou / Dubaï : Thursday, June 23rd 2022 from 08pm to 09pm (GMT+2)
Bangkok : Thursday, June 23rd 2022 from 11pm to 12am (GMT+2)
Shanghai : Friday, June 24th 2022 from 12am to 01am (GMT+2)
Tokyo : Friday, June 24th 2022 from 01am to 02am (GMT+2)
Sydney : Friday, June 24th 2022 from 03am to 04am (GMT+2)
Wellington : Friday, June 24th 2022 from 05am to 06am (GMT+2)

Drug Coated Balloons - Unanswered Questions from the last 3 Webinars

Share
May 2017
Honolulu : Tuesday, May 16th 2017 from 11:30pm to 12:30am (GMT+2)
San Francisco : Wednesday, May 17th 2017 from 02:30am to 03:30am (GMT+2)
New York : Wednesday, May 17th 2017 from 05:30am to 06:30am (GMT+2)
Buenos Aires : Wednesday, May 17th 2017 from 06:30am to 07:30am (GMT+2)
Reykjavik : Wednesday, May 17th 2017 from 09:30am to 10:30am (GMT+2)
London / Dublin : Wednesday, May 17th 2017 from 10:30am to 11:30am (GMT+2)
Paris / Berlin : Wednesday, May 17th 2017 from 11:30am to 12:30pm (GMT+2)
Istanbul : Wednesday, May 17th 2017 from 12:30pm to 01:30pm (GMT+2)
Moscou / Dubaï : Wednesday, May 17th 2017 from 01:30pm to 02:30pm (GMT+2)
Bangkok : Wednesday, May 17th 2017 from 04:30pm to 05:30pm (GMT+2)
Shanghai : Wednesday, May 17th 2017 from 05:30pm to 06:30pm (GMT+2)
Tokyo : Wednesday, May 17th 2017 from 06:30pm to 07:30pm (GMT+2)
Sydney : Wednesday, May 17th 2017 from 08:30pm to 09:30pm (GMT+2)
Wellington : Wednesday, May 17th 2017 from 10:30pm to 11:30pm (GMT+2)

Discussion around complex PCI

How to deal with complications?

Share
Tuesday, October 25th 2022 from 06pm to 07:15pm (GMT+2)
Honolulu : Tuesday, October 25th 2022 from 07am to 08:15am (GMT+2)
San Francisco : Tuesday, October 25th 2022 from 10am to 11:15am (GMT+2)
New York : Tuesday, October 25th 2022 from 01pm to 02:15pm (GMT+2)
Buenos Aires : Tuesday, October 25th 2022 from 02pm to 03:15pm (GMT+2)
Reykjavik : Tuesday, October 25th 2022 from 05pm to 06:15pm (GMT+2)
London / Dublin : Tuesday, October 25th 2022 from 06pm to 07:15pm (GMT+2)
Paris / Berlin : Tuesday, October 25th 2022 from 07pm to 08:15pm (GMT+2)
Istanbul : Tuesday, October 25th 2022 from 08pm to 09:15pm (GMT+2)
Moscou / Dubaï : Tuesday, October 25th 2022 from 09pm to 10:15pm (GMT+2)
Bangkok : Wednesday, October 26th 2022 from 12am to 01:15am (GMT+2)
Shanghai : Wednesday, October 26th 2022 from 01am to 02:15am (GMT+2)
Tokyo : Wednesday, October 26th 2022 from 02am to 03:15am (GMT+2)
Sydney : Wednesday, October 26th 2022 from 04am to 05:15am (GMT+2)
Wellington : Wednesday, October 26th 2022 from 06am to 07:15am (GMT+2)

The role of hemodynamic support in cardiogenic shock:

When to escalate and when to de-escalate

Share
Friday, February 17th 2023 from 12:30pm to 02pm (GMT+1)
Honolulu : Friday, February 17th 2023 from 01:30am to 03am (GMT+1)
San Francisco : Friday, February 17th 2023 from 03:30am to 05am (GMT+1)
New York : Friday, February 17th 2023 from 06:30am to 08am (GMT+1)
Buenos Aires : Friday, February 17th 2023 from 08:30am to 10am (GMT+1)
London / Dublin : Friday, February 17th 2023 from 11:30am to 01pm (GMT+1)
Paris / Berlin : Friday, February 17th 2023 from 12:30pm to 02pm (GMT+1)
Istanbul : Friday, February 17th 2023 from 01:30pm to 03pm (GMT+1)
Moscou / Dubaï : Friday, February 17th 2023 from 03:30pm to 05pm (GMT+1)
Bangkok : Friday, February 17th 2023 from 06:30pm to 08pm (GMT+1)
Shanghai : Friday, February 17th 2023 from 07:30pm to 09pm (GMT+1)
Tokyo : Friday, February 17th 2023 from 08:30pm to 10pm (GMT+1)
Sydney : Friday, February 17th 2023 from 09:30pm to 11pm (GMT+1)
Wellington : Friday, February 17th 2023 from 11:30pm to 01am (GMT+1)

Coronary sinus reducer

Share
Scroll Up