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SYMPOSIUM: QUAND C’EST CALCIFIÉ !!!
IVL: Vaisseaux périphériques
Pierre ROBERT – CCA, CHU Montpellier
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CONFLITS D’INTERET
• Aucun
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VAISSEAUX PÉRIPHÉRIQUES
1. Permettre un TAVI transfémoral
2. Membres inférieurs
3. Malexpansion de stent
4. Autres situations
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1. PERMETTRE UN TAVI TF
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1. PERMETTRE UN TAVI TF: LES ÉTUDES
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1. PERMETTRE UN TAVI TF: LES ÉTUDES
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1. PERMETTRE UN TAVI TF: LES ÉTUDES
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1. PERMETTRE UN TAVI TF: LES ÉTUDES
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1. PERMETTRE UN TAVI TF: LE MATERIEL
• Shockwave M5 :
OTW
⌀ : 3.5mm 7mm x 60mm
6F (≥6.5mm = 7F)
Guide 0.014
Inflation à 4 atm
30 impulsions/cycle
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1. PERMETTRE UN TAVI TF: CAS
Initiale
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1. PERMETTRE UN TAVI TF: CAS
7 x 60mm IVL balloon Post balloon angio
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1. PERMETTRE UN TAVI TF: CAS
CV 29mm, 16F Angio finale14F
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2. MEMBRES INFERIEURS: LES ÉTUDES
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2. MEMBRES INFERIEURS: CAS
Initiale
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2. MEMBRES INFERIEURS: CAS
7 x 60mm IVL balloon 9 x 57mm stent
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2. MEMBRES INFERIEURS: CAS
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2. MEMBRES INFERIEURS: BTK
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3. MALEXPANSION DE STENT
Honton et al, JACC Interv, 2019
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4. AUTRES SITUATIONS
Carotide:
Grillo et al, Arch Athroscler Dis, 2019
TABC:
Cesare et al, Clin Med Insight, 2019
Rénale, sous clavière…
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IVL ET PÉRIPHÉRIQUE: THM
• L’IVL peut permettre un TAVI TF jugé « impossible » sur le TDM
• Stratégie IVL + TAVI TF doit être comparée aux autres voies alternatives
• IVL + ballon actif futur gold standard de l’angioplastie fémorale ?
• IVL dans la malexpansion de stent
• Usages « off label » Nécessité d’études+++