By Stéphane Rinfret
A useful and technical instruction manual supplying operators with a step by step description of the way to accomplish many of the options desirous about the techniques, and the way to troubleshoot a few of the difficulties alongside the way in which. Examples with photos might be supplied, in addition to reside angiographies. on the finish of every bankruptcy, the writer might be supplied with three inquiries to solution. these questions should be built via the editor and the members. the assumption is to supply a brief connection with the most up-tp-date difficulties encountered with a selected factor built within the bankruptcy. these days, the busy clinician is not likely to solely depend upon long textbooks to profit particular complicated recommendations. that's one of many purposes for the recognition of CTO classes, reside demonstrations, and meetings and, there are therefore many classes provided worldwide to assist new operators within the box. CTO PCI has emerged as a truly potent technique to assist sufferers with CTOs, with very excessive luck and coffee problems premiums. it's even if a truly difficult method with a number of pitfalls alongside the right way to luck, either in particular instances, but additionally within the studying approach. There are at the moment no unmarried reference or "one-stop store" for the operator who desires to study a given approach that she or he may perhaps has noticeable played reside in a devoted proctorship occasion, or in a stay demonstration, or to even troubleshoot an issue encountered in day-by-day CTO PCI perform. this can be the 1st guide formatted for the busy interventional heart specialist. This e-book becomes a “must have” for operators who're training CTO PCI and who desire a fast reference. besides the fact that, it is going to additionally offer counsel and methods at present utilized in the field.
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Extra resources for Percutaneous Intervention for Coronary Chronic Total Occlusion: The Hybrid Approach
The first clinical experience with a novel catheter for 3 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. What Equipment Should Be Available? collateral channel tracking in retrograde approach for chronic coronary total occlusions. JACC Cardiovasc Interv. 2010;3: 165–71. McClure SJ, Wahr DW, Webb JG. Venture wire control catheter. Catheter Cardiovasc Interv. 2005;66:346–50. Naidu SS, Wong SC. Novel intracoronary steerable support catheter for complex coronary intervention. J Invasive Cardiol. 2006;18: 80–1.
To date, most operators found the catheter to be stiffer than the Corsair. It is therefore best suited for septal than in epicardial collaterals, or for antegrade work. 7 mm from the tip (Fig. 1b). It is particularly useful for navigating tortuous epicardial collaterals, and is still the preferred antegrade microcatheter for many operators. Venture The Venture catheter (Vascular Solutions, US, Fig. 5 mm [6–11]. By clockwise rotation of a thumb wheel on the external handle the tip can be deflected up to 90°.
If suitable interventional collaterals are present, a retrograde strategy can be pursued. J. Nicholson a b d c f e Fig. 2 Tip deflection and torque technique using the Gaia wire. 1). 2). 3). (d–i) Through the Corsair, the wire was exchanged for a Gaia 3rd, and the wire is pushed up to feeling resistance and noticing a tip deflection. The tip is then rotated about 90–180° and the wire re-advanced. 4). 6) 4 Specific Basic Techniques to Master in CTO PCI 37 g h i j k Fig. J. Nicholson and there is an appropriate distal vessel, antegrade DR can be pursued.