BTK Intervention · Hiroshi Ando, MD Heart Center, Kasukabe Chuo General Hospital Saitama, Japan...
Transcript of BTK Intervention · Hiroshi Ando, MD Heart Center, Kasukabe Chuo General Hospital Saitama, Japan...
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Hiroshi Ando, MD
Heart Center,
Kasukabe Chuo General Hospital
Saitama, Japan
BTK Intervention - Overview and Video live -
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Disclosure
Speaker name: Hiroshi Ando
I have the following potential conflicts of interest to report:
Consulting
Employment in industry
Stockholder of a healthcare company
Owner of a healthcare company
Other(s)
I do not have any potential conflict of interest
✔️
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ESC 2011 guideline - Tibio-Peroneal lesions -
Eur Heart J. 2011;32:2851-906
EVT
first !
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A Variety of 0.014inch wires
Terumo
• Runthrough Ph, Naveed 4 (Tapered 1, Floppy 1, Hard 15/30/50)
ASAHI INTEC
• Cruise (Regalia), X-treme PV, Agosal XS, Treasure XS, Gradius
• Astato XS 9-12/9-40, Halberd
Lifeline
• Wizard PV 1/3/6/X, Joker PV
Kaneka
• Athlete Ruby (Soft, Intermediate, Hard, Superhard, Support)
Cordis
• Chevalier (Floppy, tapered 3/15/30, PL-X, Universal)
Boston
• Aguru (Floppy, Support, Ultra, Pierce, HC), Jupiter Max
Abbott
• Command, Winn 40/80/200T Japanese product
Foreign product
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Personal Preference
Product Core Coating Polymer length Outer diameter (inch)
Cruise (Regalia) Stainless Polymer Jacket + Hydrophilic 22cm 0.014
Naveed4 Floppy1 Stainless
Polymer Jacket + Hydrophilic 18.5cm 0.014
Chevalier Floppy Stainless
Polymer Jacket + Hydrophilic 12cm 0.014
HT Command Nitinol Polymer Jacket + Hydrophilic 28cm 0.014 Nitinol CORE-TO-TIP
Athlete Wizard PV3
Stainless
Dipping Polymer + Hydrophilic 17cm 0.010-0.014
Athlete RUBY PT Hard
Stainless
Hydrophilic 0.014
Chevalier PL-X Stainless
Polymer Jacket + Hydrophilic 12cm 0.014
ASAHI Halberd Stainless
Hydrophilic 0.014 1mm Pre-shape
Astato XS 9-12 Stainless
Hydrophilic 0.009-0.014
Astato XS 9-40 Stainless
Hydrophilic 0.009-0.014
Naveed4 Hard50 Stainless
Hydrophilic 0.013-0.014
Jupiter MAX Stainless
Hydrophilic 0.013-0.014
1mm Pre-shape
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Personal Preference
1 1 2 2,8 3 9 10 12 12
40
50
100
0
20
40
60
80
100
120
soft
Tip load ( g )
Soft Intermediate Hard
Pre-shape
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New Issue After passing the wire,
no device can pass through the lesion!
Low profile balloon
Microcatheter
Tornus PVⓇ
Additional wire (Crusade PVⓇ)
CrosserⓇ
Excimer laserⓇ
RotablatorⓇ
GuideLinerⓇ
Subintimal passage
Needle cracking technique
Brockenbrough needle
Tag of wire
....
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Needle cracking technique
63y Male
CLI,DM
SFA 75%
Pop 90%
PT 100%
ATA 100% DPA 100%
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Needle cracking technique
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Needle cracking technique
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Needle cracking technique
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New Issue After passing the wire,
no device can pass through the lesion!
Low profile balloon
Microcatheter
Tornus PVⓇ
Additional wire (Crusade PVⓇ)
CrosserⓇ
Excimer laserⓇ
RotablatorⓇ
GuideLinerⓇ
Subintimal passage
Needle cracking technique
Brockenbrough needle
Tag of wire
....
Balloon Deployment using
Forcible Manner BAD FORM Technique
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Case: Male, 73 years
Rt. ATA, PE occlusion
Clinical data:
PAOD, Bil. CLI, Rt. big toe and lateral foot non-
healed
ulcer, rest pain
Rutherford 5
Recanalization of the Lt. ATA, PTA 01/2015
Recanalization of the Rt. SFA(STENT implantation),
TPT, PTA(POBA), ATA Balloon not cross 04/2015
ABI: 0.75
CAD, Post PCI
Diabetes Mellitus
ESRD(Hemodialysis)
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1st EVT, 04/2015
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2nd EVT, 05/2015
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Where there’s a will there’s a way !
Thank you for your attention.