Coronary bifurcation stenting: modern algorithms and details of provisional techniques- Elias Hanna
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- čas přidán 22. 07. 2024
- 0:00 Modern classification of bifurcation lesions into 3 subtypes (beyond Medina): non-true bifurcation, true bifurcation, and complex true bifurcation
10:55 Data for the 3 potential approaches to bifurcation stenting: provisional with leave-SB-alone strategy, true provisional, planned 2-stent strategy
17:16 Answers to the 7 decision steps of coronary bifurcation stenting (e.g., when to double wire? predilate? postdilate? when to provisionally stent?)
24:20 Algorithm for non-true bifurcation. Plaque shift vs carina shift
29:59 Algorithm for true bifurcation and complex true bifurcation. Technical details of every step-Value of POT-Stent sizing distally vs proximally
50:57 Role of FFR in assessing SB residual stenosis
53:50 Additional technical tips, particularly how to rewire SB
1:03:40 Provisional stenting: T stent And Protrusion (TAP) technical steps. How to apply it and how to optimize it. TAP vs reverse crush vs culotte
1:13:02 Jailed balloon novel technique
Thank you Dr. Hanna! You are a gifted teacher and this is the best and most practical narrative on bifurcation stenting. Will be anxiously waiting for the sequel on this topic.
🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳👍🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳🥳
MASHALLAH, what an amazing lectures, never seen before. Really Great sir🙏
Thank you Professor Hanna, amazing talk!
A marvelous lecture from an outstanding professor. Thanks alot
Amazing video as always Dr. Hanna! Looking forward to the new edition of your textbook. Already read the last one and it was great.
brilliant presentation. very lucid and practical. Always on the look out for your talks
Amazing Video. Thank you Dr. Hanna
It is a phenomenal talk as usual. We are lucky to have Dr. Hanna at University of Iowa. We look forward to the new edition of your amazing book.
Thank you for being a great physician and teacher
Thanks a lot
Great teaching !
Please continue
Thanks a lot. Very informative. Keep posting
As usual; another excellent presentation, passionately waiting for your talk regarding CTO intervention
I wished to have u as a Mentor in my Hospital in Germany
We all do!
how can i connect with you? @nikesnipe
@@rezaulislam8953 hello!
one of the best teachers
Excellent video..thank you very much
Mashallah you are a great teacher
I loved it … very useful
May Allah swt bless you for being so generous and making it easier for others to learn. Waiting for talk cullotte and DK crush techniques and PCI of LMS.
I pray that your teaching sessions will raise your darajaat snd will be sadqa i jaariyah for u.
Thanks a lot very illustrative presentation
Thank you for sharing this information
As always excellent sir….👌👌👌
Great presentation again👏🏻👏🏻👏🏻👏🏻
Best lectures
great. thanks !!!
Thank you sir
thank you sir a million
There is another provisional stent strategy not discussed. We students named this strategy after our beloved mentor who would usually say after he snow ploughed a relatively small branch… “ You didn’t need that branch “
Excellent
thank you
Dr.Hanna great lecture! is it possible to download text presentations? it would help a lot because English is not my primary language.
in provisional techniqe what do you think for avoid wire rapture do rewiring before pot
Big Fan of you sir😍
Best! please keep on making more conceptual cardiology lectures. Studying and enjoying from ELIAS B HANA 2nd edition book probably the BEST CARDIOLOGY BOOK
Sir stay blessed. Sir kindly make other videos for intervention and general cardiology also basics tips and tricks. It’s really make my day. Sir any book of your regarding intervention cardiology. ???
Sir can you plz share the presentarion
Great 8
Dr thx for great presentation again... can take
it pdf or send to me
thank you so much for your great lecture. Can you elaborate the reason why PLAQUE SHIFT produces more severe outcome compared to CARINA SHIFT, since previously I thought that plaque shift during main branch stenting will be easy to break down while carina shift creates a new form of solid stent therefore not functionally
A nice study published in CCI showed that CARINA shift is rarely associated with FFR compromise, while PLAQUE shift, which is less common than carina shift, is the one that causes functional FFR compromise. onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.24956 The likely reasons are 3-fold: (1) carina shift is a very focal process (functional effect correlates with how long the lesion is, beside how tight); (2) Carina shift is an eccentric geometric distortion: the lumen is not as narrow in 3 D as it may appear in one view; (3) possibly, vasoreactivity is more preserved when there is less plaque. Imagine carina shift as squashing of the SB ostium and changing it from a circle to an ellipse: the overall area is less reduced than if you shift plaque. This is good news, as carina shift is more easily prevented by: (i) avoid MB stent oversizing (side to distal vessel); (ii) POT of proximal MB stent
It is all about plaque burden. Plaque burden of MB and SB predicts plaque shift. This explains why in the definition of complex true bifurcation (higher risk of SB occlusion), plaque burden is key: length of SB disease>10 mm, heavy plaque burden in the main vessel, heavy calcium.
@@eliashanna8248 it's so great to hear this explanation. I learned a lot and really appreciate your explanation
I beg ALLAH to bless your age, life, and health.