By Antonio Colombo, Goran Stankovic

A trailblazer in interventional cardiology, Dr. Antonio Colombo combines his significant adventure with that of Goran Stankovic and uncommon colleagues to proportion assistance and tips for facing diseased coronary arteries. even if discussing his 'crushing and kissing' concepts or the stenting of tortuous vessels within the aged, Dr. Colombo and his colleagues' texts and case commentaries give you the reader with succinct and easy suggestion in accordance with own adventure. they supply the main complete and functional advisor on hand for these occupied with coronary artery stenting. the pictures are all down-loadable in Powerpoint and may be of super use to teachers and scholars alike.

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Additional resources for Colombo's Tips & Tricks for Drug Eluting Stents

Example text

We doubt whether the literature will give us any new important information to answer this question.  If all the above maneuvers are difficult, a new wire needs to be used to access the side branch.  In case of no success, reshaping of the tip with a wider, >90° curve, should be attempted.  The fact that the probing catheter is advanced over the wire coaxial to the stent deployed in the main branch will also prevent the second wire from engaging below the struts of the main­branch stent.  The inflation pressure should also be kept well under the rated burst pressure because balloon rupture within a stent strut can also cause balloon entrapment.

A sub­study will assess the optimal anti­ thrombotic regimen comparing unfractionated heparin plus a IIb/IIIa inhibitor to bivalirudin and bail out IIb/IIIa inhibitor (slide 67). The SYNTAX trial has a novel design in which consecutive patients with three­vessel disease including left main lesions will be randomized between PCI and surgical Page 20 revascularization; patients deemed unsuitable for randomization will be followed in either the PCI or CABG registry (slide 68). SYNTAX will provide the evidence base for or against surgical conversion to PCI (slide 69).

The goal is to make the procedure safe, basically to avoid any risk of thrombosis by paying attention to appropriate antiplatelet therapy and optimal stent implantation, and finally to make it effective by avoiding restenosis.  When we utilize a second wire, we always deliver the stent on the softer wire and leave the support wire like ‘iron­man’ or ‘stabilizer’ as a buddy­wire (slide 3). It may be possible that, in the future, with the advent of more flexible and lower­profile drug­eluting stents, some of the delivery problems will be improved.

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