1430_Goueffic.pdf

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1、How I Cross Challenging Calcified SFA:Access,Technique,Wires and DevicesY.Gouffic,MD,PhDDepartment of vascular and endovascular surgery,Groupe Hospitalier Paris Saint Joseph,Paris,France.Y.Gouffic reports:Research funding from Abbott,Bentley,General Electric,Sensome,WL GorePersonal fees and grants f

2、rom Abbott,BD,Bentley,Biotronik,Boston Scientific,Cook,General Electric,Medtronic,Penumbra,Shockwave,WL Gore(medical advisory board,educational course,speaking)DisclosuresMediacalcosis/Intimal calcificationsMonckebergs medial sclerosisAtheromatous plaqueIntimal CalcificationsSteenman,Gouffiic,Scient

3、ific Reports,2018Espitia,Gouffic,PLOSone,2018Lack of a uniform accepted calcium scoring systemUndergoing trials use a variety of subjective,semi-quantitative,angiographic,and fluoroscopic-based assessments of VC severity.-the degree of vessel wall calcium based on a single AP or two orthogonal angio

4、graphicand/or fluoroscopic views-the presence of one-sided versus circumferential vessel wall calcification;and define the length of VCRocha-Singh,Catheter Cardiovasc Interv.2014 Femoro-Popliteal AlgorythmVessel preparationDefine the approachDefinitive treatmentCross the lesionGouffic Y,EMC,2022 Dub

5、osq M,Gouffic Y,Medicina(Kaunas),2022Access(ante/retrograde access)Re-entry devicesGuidewiresCommon challengesTip fails to enter lesion Wire tip buckles against lesionTip enters lesion but wire fails to follow+Wire body curves and bucklesWire enters Subintimal space but fails to re enter true lumenW

6、ire Crosses but device fails to crossWire Prolapses on entry or Flips out on Device Delivery Failure to select a side branch“My”0.014 and 0.018 guidewires for BTK proceduresIntra vs Sub-Intimal Crossing:No differences in term of OutcomesSoga,J Vasc Surg,20132-year restenosis rates were comparable af