Thanks. Just one question. When doing a "POT" in our lab, we just pull the stent-balloon back and do the POT with the stent-balloon. Is there any serious problem with such a technique? Or do we have to use a special balloon such as a NC-balloon? Thanks in advance for your answer.
We cannot use the same ballon. First reason is that it will also dilate the distal MV leading to carina shift. Second reason is that it can cause dissection in the unstented part of the proximal MV. However it can be done in LM Ostia lesions, if the entire stent ballon in pulled in LM and no part lies in LAD.
Thank you very much, very beneficial information. My English is not well. I have trouble understanding videos sometimes. Can you put subtitles in English please?
It is uncommon to have difficulty retrieving jailed wires. When it happens I do not pull hard - instead I advance a microcatheter or balloon as far as possible and then withdraw the wire.
awesome as usual! I find it sometime difficult to decide whether the side branch needs to be stented or not, for example a long diagonal brach with a diffuse disease but a vessel less 2mm or less. What is your approach? Do you stent vessels of 2 mm or less? what about the use of DEB? could that be an option in such cases?
Usually do not stent small vessels, in most cases provisional work. If patient develops ischemia after jailing, balloon angioplasty usually suffices. DCBs are not approved for clinical use in the US but they seem to be highly promising for treating the side branch of bifurcation lesions.
Thank You so much professor! When performing bifurcation stenting, in particular when performing kissing baloons technique, the wires inside the vessel are often intertwined. What recommendations can you give?
Balloon sizing is based on Finet's law: effective diameter of 2 balloons inflated side by side is (diameter of balloo 1 + diameter of balloon 2) x 2/3. Will typically do 2 step-kiss: high pressure (20+ atm) of the side branch balloon first, then lower pressure to 10-12 atm followed by inflation of the main vessel balloon at the same pressure. Will deflate balloons simultaneously.
Thank you very much, very beneficial information.My English is not well.I have trouble understanding videos sometimes.Can you put subtitles in English please?
