Random titbits in interventional cardiology

Random titbits in interventional cardiology

Random titbits in interventional cardiology: Changing of guide with coronary guide wire in situ – using docking and wire extension – may not support an Amplatz guide

SAFER trial – landmark trial on embolic protection devices in SVG
No evidence for use of GP IIb/IIIa in SVG – Circulation 2002
Preferred strategy for LIMA anastomotic site lesion (AJC; 2004; 95:1531)

Preferred strategy for LIMA anastomotic site lesion is balloon dilatation and provisional stenting if necessary. Restenosis after POBA to LIMA distal site is low while stenting has higher restenosis. JACC 200; 35:944. These could be pre DES data and current data is needed.

DPD in SVG PCI – Use always when technically feasible

DES in SVG: No definite advantage for DES in SVG of 3.5 mm or more in size. So use only in selected cases.

Pattern of restenosis in BMS vs DES: Restenosis in BMS is more diffuse and severe and difficult to tackle with drug eluting balloon (DEB) alone. Focal lesions are seen with SES and more diffuse lesions in PES

Jailing of a hydrophilic wire may not be good as the coating of the wire may be left inside while pulling out.

ARCAOS Aberrant RCA from opposite sinus

Dot and eye sign: Anomalous LMCA from R sinus? AJC 1985. 55:770
Anomalous coronary origin interarterial course is dangerous Circulation. 2002; 105:2449

Buddy wire

FFR in tandem lesions If there are two tandem lesions which are separated by more than 6 times the vessel diameter, they behave independently on FFR.

Covered stents: Covered stents are usually have PTFE covering. Another method of producing covered stent is to suture a saphenous vein to the stent. But then it becomes quite bulky and difficult to cross the lesion.