慢性完全性闭塞的导丝技术介绍PPT.ppt

Introduction wire techniques of chronic total occlusions;Contents;Definition of CTO;The Spectrum of Lumen Morphology in CTO: Clinical Challenges;Chronic Total Occlusions;Variables related success;Anatomic Descriptorsof Procedural Success;;;;;Hallmarks of a CTO Guidewire;ASAHI MIRACLEBROS? 3;;ASAHI CONFIANZA? 9;;;Cordis SHINOBI SHINOBI PlusCTO Guidewires;1. Coronary CTOs have many types of lesion morphologies.;Guide Wire Selection;Hydrophobic vs.. Hydrophilic Wires;Simplifyed sequence of wires;Why so difficult to cross it ?;Sub-Intimal Path;Wire technique for locating another channel –Tip Shape Is Key;Wire tip for CTO;;Guidewire Operator Techniques;DRILLING (controlled);PENETRATION;Allways steer towards inner curve ! Twist gently , push and pull ! Dont inject dye via OTW-catheter !;In curved vessels, the optimal site for penetrating the fibrous cap is towards the myocardium (mural ) ;Penetration vs. Controlled Drilling ≠ Drilling;Techniques of CTO Guidewire Manipulation;SLIDING;;DRILLING (controlled);PENETRATION;SLIDING;;DRILLING (controlled);PENETRATION;SLIDING;Recent Guidewire Techniques ;Concept of Parallel Wire Technique;Tortuousity - Lesion on Bend;;Seesaw: modifyed parallel wire technique;Seesaw WiringParallel Wire Method with Double Support Catheters;Seesaw Wiring ;CTO at branch:Sesame open (Saito);Side Branch Technique ;Anchoring technique using OTW balloon;Subintimal Tracking and Reentry (STAR)technique;Anterograde Dissection and Reentry;Subintimal Tracking and Reentry (STAR)Tips;Subintimal Tracking and Reentry (STAR)Patient Selection;Interventional techniques Improvement about CTO ;Retrograde approach;;CTO Guide Wire Considerations(1);Entry;■ MIRACLEbros Family ■ Confianza Family;■ MIRACLEbros Family ■ Confianza Family;Support Catheters;Conquering Chronic Total Coronary Occlusions:  newest technical approaches ;;Bottom line for CTO management ;Procedural stopping points :;