ivus-guided sfa intervention · •combination of ivus and wire preceding technique is logical,...

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IVUS-guided SFA intervention Daizo Kawasaki, MD Morinomiya Hospital, Osaka, Japan

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Page 1: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

IVUS-guided SFA intervention

Daizo Kawasaki, MD

Morinomiya Hospital, Osaka, Japan

Page 2: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

Disclosure

Speaker name: Daizo Kawasaki

.................................................................................

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

Page 3: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

2.9 Fr (distal shaft)

2.5mm

9.0mm

2.5 Fr (distal shaft)

20mm

2.4 Fr (distal shaft)

Eagle Eye® Platinum ST (Volcano)

Navifocus WR (Terumo)

OptiCross (Boston)

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Page 4: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

wire preceding

IVUS-guided technique for long SFA CTO

Prox

Mid

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IVUS preceding

wire preceding

Wire preceding

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IVUS preceding

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Page 5: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

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Wire preceding technique

Page 6: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

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IVUS preceding technique

Page 7: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

60’ male : Rutherford class-3

Stump +

SFA long CTO

Page 8: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

Wire preceding

CTO-entrance

IVUS GC

Page 9: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

IVUS preceding

SFA-proximal to mid

Page 10: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

IVUS preceding

SFA-distal

Page 11: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

Wire preceding

SFA-distal

Page 12: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

IVUS preceding

CTO-exit

Page 13: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

50’ male Rutherford class-3

Stump -

SFA long CTO

Page 14: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

CTO-entrance

IVUS guided parallel wire technique

Page 15: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

IVUS preceding

SFA-proximal to distal

Page 16: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

Wire preceding

CTO-exit

Page 17: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

70’ male Rutherford class-3

Page 18: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

Add distal access immediately

Page 19: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

IVUS guided Rendez-vous technique

Page 20: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

Summary

• It is very important to get intraluminal at the CTO-entrance

to protect DFA flow

• Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique

• We can decide next strategy according to IVUS information of just before CTO-exit

Page 21: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

Thank you!!

For Save Legs, Save Patient’s Life

My Best Team

Page 22: IVUS-guided SFA intervention · •Combination of IVUS and wire preceding technique is logical, safe, and quick as well as looped wire technique •We can decide next strategy according

IVUS-guided SFA intervention

Daizo Kawasaki, MD

Morinomiya Hospital, Osaka, Japan