25.2 How to prevent and treat coronary dissections

Step-by-step description of how to prevent and treat coronary dissections

[@shangz0216]

Thanks for your educative presentation.

[@Ashmisf]

Good presentation and easily understand

[@Kulseref]

Thank you for the great education Dear Brilakis. I have 2 questions:
1. What is the best wire passing to true lumen for the iatrogenic coronary diseections (workhorse/ hydophilic/polimer jacketed/ stiff or escalating)?
2. If the imaging (IVUS/OCT) is not possible, would it be appropriate to use microcatheter to confirm the true lumen (contrast injection via micro after pass the dissection)?

[@manosbrilakis]

1. Workhorse wire
2. Would advise against injecting contrast, as it will make things much worse if you are in the subintimal space.

[@rajmaster0]

how did you advance the guidewire for the case at 4:56 knowing it was in true lumen?

[@manosbrilakis]

Contralateral injection was the key for confirming that that guidewire was inside the distal true lumen.

[@yyshiao]

Dr. Brilakis, Thanks for sharing this lecture. I have a question, what kind of post intervention coronary dissection is better observed rather than treated? same algorithm as SCAD?

[@manosbrilakis]

Small, non-flow limiting dissections can sometimes be left untreated unless they involve a major vessel, such as the left main.

[@yyshiao]

@@manosbrilakis thanks~

[@mohammedelbarbary8708]

nice video

[@mohamedaymenbenabdessalem1160]

Thanks for this great lecture. A question please : Any experience with type E dissection, and how to deal with ?

[@manosbrilakis]

Stenting is the solution for such dissections.

[@mohamedaymenbenabdessalem1160]

@@manosbrilakis thanks for your answer.