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Welcome #cardiotwitter #tweetorial on how to use guide extensions in PCI. In the presented case it was difficult to deliver ballon&stents despite good lesion prep. and extra support wire. This what the guide ext. are made for @AGIKinterv @PCRonline #ACCFIT @mmamas1973 @BotPci
Insert a guide ext. over an extra support wire into the vessel. Typically it won't go over the 1st corner in heavily Ca++ @ShariqShamimMD @cardionerds @mirvatalasnag @HolgerNef @AndrzejWierucki #CardioEd @SABOURETCardio @doconmoney @ahmedknhi @billgogas @BaoGTran @sbrugaletta
To facilitate further advancement of the guide ext. inflate a balloon in the distal portion of the vessel. In most cases pushing the guide ext will be possible. If not, pulling the balloon gently with counteractive push on the extension will lead to a deep seating of the device.
As you can see even a quite long 4 mm stent can now be delivered without any problems
@polivenok @yeh_james3 @naderjo @turilrh @jedicath @w_jyg @jmahmed @nagkulari @KambisMashayek1 @lorenzo2509 @lamelaspablo @Less_is_more_1 @RodrigogpLima @MichaelMegalyMD @NMerke @mornei2011
@polivenok @yeh_james3 @naderjo @turilrh @jedicath @w_jyg @jmahmed @nagkulari @KambisMashayek1 @lorenzo2509 @lamelaspablo @Less_is_more_1 @RodrigogpLima @MichaelMegalyMD @NMerke @mornei2011
After successful stent deployment it may be necessary to put the guide ext. into the stented segment. It's easier if you let the guide ext. "slide" over the stent ballon
@BartOlechowski @Basalus @aayshacader @DFCapodanno @LChristianNapp @Almanfi_Cardio @doconmoney @evandrofilhobr
@BartOlechowski @Basalus @aayshacader @DFCapodanno @LChristianNapp @Almanfi_Cardio @doconmoney @evandrofilhobr
After delivering the stent don't forget to remove the guide ext. before you deploy it
After placing the stents the postdilatation can usually be done w/o guide ext. @EuroInterventio @HeartOTXHeartMD @HadyLichaaMD @AntoniousAttall @timir_paul @GreggWStone @CardioIAN @stefan_harb
After placing the stents the postdilatation can usually be done w/o guide ext. @EuroInterventio @HeartOTXHeartMD @HadyLichaaMD @AntoniousAttall @timir_paul @GreggWStone @CardioIAN @stefan_harb
One untypical example: #rotablation over a guide ext. to protect previously implanted stents (caveat: interaction between burr and cable to which guide extention is attached, mainly during burr advancement) @aayshacader @agtruesdell @TransradialP @FurquimThyago @UjjwalRastogiMD
If the guide ext. collapses under the calcified vessel wall, making advancement of the stent impossible, you can dilate it, it works on most of the cases.
@Tesslagra @UjjwalRastogiMD @Umair2017 @drumairasg @Uqayyum123 @EulertJ @uribemd72 @MarcVorpahl @tonyhvo
@Tesslagra @UjjwalRastogiMD @Umair2017 @drumairasg @Uqayyum123 @EulertJ @uribemd72 @MarcVorpahl @tonyhvo
Any other ideas? Post them here, let's learn from each other 
@flocuc @MatthiasBossard @clin_owl @HemodinamicaVLC @TallRoundsTM @MayoClinic @tonyhvo @troleder @PBasiukiewicz @maciejdyrbus @NadelMaciej @Maciek24909961
@flocuc @MatthiasBossard @clin_owl @HemodinamicaVLC @TallRoundsTM @MayoClinic @tonyhvo @troleder @PBasiukiewicz @maciejdyrbus @NadelMaciej @Maciek24909961
