asuccessfulivusa successful ivus ...summitmd.com/pdf/pdf/2066_kumada.pdf · asuccessfulivusa...

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A successful IVUS-guided PCI case for obtuse A successful IVUS guided PCI case for obtuse marginal branch ostial CTO lesion with antegrade approach using the dual 6Fr Catheter Intervention & EP antegrade approach using the dual 6Fr guidings’ system Advanced Cardiovascular Th ti Advanced Cardiovascular Th ti Masahiro Kumada, Satoru Sumitsuji, Koichi Tachibana, Therapeutics Therapeutics Tadashi Kuroda, Isamau Mizote, Seiko Ide, Keita Okayama, Kensuke Yokoi, Togo Iwahana, Shinsuke Nanto Education and Clinical Research Department of Advanced Cardiovascular Thera peutics Osaka University Graduate School of Medicine, Japan ANGIOPLASTY SUMMIT TCTAP 2012 April 25 th , 2012, SEOUL, KOREA

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Page 1: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

A successful IVUS-guided PCI case for obtuseA successful IVUS guided PCI case for obtuse marginal branch ostial CTO lesion with antegrade approach using the dual 6Fr

Catheter Intervention & EP

antegrade approach using the dual 6Fr guidings’ system

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th ti

Masahiro Kumada, Satoru Sumitsuji, Koichi Tachibana,

TherapeuticsTherapeuticsTadashi Kuroda, Isamau Mizote, Seiko Ide,

Keita Okayama, Kensuke Yokoi, Togo Iwahana, Shinsuke Nanto

Education and Clinical Researchy g

Department of Advanced Cardiovascular Therapeuticsp p

Osaka University Graduate School of Medicine, Japan

ANGIOPLASTY SUMMIT TCTAP 2012 April 25th, 2012, SEOUL, KOREA

Page 2: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

Case : a 54-year-old manCase : a 54 year old man

Clinical course

Catheter Intervention & EP

Clinical course

2011/6 Severe chest pain on his job

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th ti

Since then angina under medication

8/19 CAG in another hospital

TherapeuticsTherapeutics(Two CTO lesions : proximal LAD, OM br.)

10/24 successful PCI for his proximal LAD CTOEducation and Clinical Research

10/24 successful PCI for his proximal LAD CTO

in our hospital

12/19 staged PCI for OM br. CTO

(ostial abrupt type)

Page 3: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for LAD (2011/10/24)PCI for LAD (2011/10/24)

Catheter Intervention & EP

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th tiTherapeuticsTherapeutics

Education and Clinical ResearchRAO30CRA30

GC : brite-tip 6FrXB3.5SH TM Balloon : NC Sprinter 2.25/12 TM

RAO30CRA30

Wire : Conquest Pro TM Stent : Nobori 2.5/18 TM

Page 4: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for OM (2011/12/19)PCI for OM (2011/12/19)

Catheter Intervention & EP

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th tiTherapeuticsTherapeutics

Education and Clinical Research

RAO30CAU25 LAO60CAU35RAO30CAU25 LAO60CAU35

Page 5: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for OM (2011/12/19)PCI for OM (2011/12/19)

Catheter Intervention & EP

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th tiTherapeuticsTherapeutics

Education and Clinical Research

CAU35CAU35 CAU35CAU35

Page 6: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for OM antegrade 1st tryPCI for OM antegrade 1st try

Catheter Intervention & EP

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th tiTherapeuticsTherapeutics

Education and Clinical Research

GC : brite-tip 6FrXB3.5SH TM IVUS : Revolution TM

Page 7: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for OM antegrade 1st tryPCI for OM antegrade 1st try

Catheter Intervention & EPGC : brite-tip 6FrXB3 5SH TM

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th ti

Wire : Conquest Pro TM

GC : brite tip 6FrXB3.5SH

TherapeuticsTherapeuticsFinecross MG TM

Education and Clinical Research

Page 8: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for OM antegrade 1st tryPCI for OM antegrade 1st try

Catheter Intervention & EPExtravasation

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th tiTherapeuticsTherapeutics

Education and Clinical Research

Page 9: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for OM antegrade 1st tryPCI for OM antegrade 1st try

Catheter Intervention & EP

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th tiTherapeuticsTherapeutics

Education and Clinical Research

Balloon : NC Sprinter2.5/15 TM

Page 10: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for OM antegrade 1st tryPCI for OM antegrade 1st try

Catheter Intervention & EP

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th tiTherapeuticsTherapeutics

Education and Clinical Research

Page 11: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for OM retrogradePCI for OM retrograde

Catheter Intervention & EP

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th tiTherapeuticsTherapeutics

Education and Clinical Research

GC : 6Fr RU TMGC : 6Fr RU TM

Page 12: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for OM retrogradePCI for OM retrograde

Catheter Intervention & EP

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th tiTherapeuticsTherapeutics

Education and Clinical Research

Wire : SUOH TMWire : SUOH TM

Micro catheter : Corsair TM

Page 13: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for OM retrogradePCI for OM retrograde

Catheter Intervention & EP

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th tiTherapeuticsTherapeutics

Education and Clinical Research

Wire : SUOH TMWire : SUOH TM

Micro catheter : Finecross MG TM

Page 14: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for OM antegrade 2nd tryPCI for OM antegrade 2nd try

Catheter Intervention & EP

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th tiTherapeuticsTherapeutics

Education and Clinical Research

GC : brite-tip 6FrXB3.5SH TM Wire : Conquest Pro TMGC : brite tip 6FrXB3.5SH

brite-tip 6FrXB3.0SH TM Corsair TM

IVUS : Revolution TM

Page 15: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for OM pre-stenting IVUSPCI for OM pre-stenting IVUS

Catheter Intervention & EP

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th tiTherapeuticsTherapeutics

Education and Clinical Research

IVUS : Revolution TM

Page 16: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for OM Balloon and StentPCI for OM Balloon and Stent

Catheter Intervention & EP

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th tiTherapeuticsTherapeutics

Education and Clinical Research

Balloon : Sprinter Legend 2.0/15 TM

Page 17: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for OM Balloon and StentPCI for OM Balloon and Stent

Catheter Intervention & EP

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th tiTherapeuticsTherapeutics

Education and Clinical Research

Stent : Nobori 2.5/28 TM

Page 18: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for OM Balloon and StentPCI for OM Balloon and Stent

Catheter Intervention & EP

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th tiTherapeuticsTherapeutics

Education and Clinical Research

Balloon : NC Sprinter 2.5/12 TM

Page 19: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for OM Final IVUSPCI for OM Final IVUS

Catheter Intervention & EP

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th tiTherapeuticsTherapeutics

Education and Clinical Research

Stent : Nobori 2.5/28 TM

Page 20: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

PCI for OM final angiogramPCI for OM final angiogram

Catheter Intervention & EP

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th tiTherapeuticsTherapeutics

Education and Clinical Research

CAU35RAO30CAU25

Page 21: AsuccessfulIVUSA successful IVUS ...summitmd.com/pdf/pdf/2066_Kumada.pdf · AsuccessfulIVUSA successful IVUS-guidedPCIcaseforobtuseguided PCI case for obtuse marginal branch ostialCTO

SummarySummary

Catheter Intervention & EPWe experienced a successful IVUS-guided PCI case for obtuse marginal branch ostial CTO lesion

Advanced Cardiovascular Th ti

Advanced Cardiovascular Th ti

with antegrade approach using the dual 6Fr guidings’ system through bilateral radial arteries.

TherapeuticsTherapeuticsEducation and Clinical Research