Yurii Melen

interventional cardiology

[Yurii Melen @MelenYurii]

@nicolasamabile Why did nt chose first options IVL?

[Yurii Melen @MelenYurii]

@mmamas1973 Did you do ivus for evaluation dissection and residual mla after cutting ballon?

[Yurii Melen @MelenYurii]

Male-UA, 3 mounth ago ivus and stenting LAD-LM and dcb for instent restenosis DES implanted https://t.co/X7zgVb85LH real time has in stent restenosis.IVUS and agressive lesion preparation, result perforation and seal after long ballon inflation.What next DCB DES or leave along?

[Yurii Melen @MelenYurii]

@evandrofilhobr Why up front did you use rota, it was uncrosable lesion, or you did ivus before rota

[Yurii Melen @MelenYurii]

@SaidAshrafMD Yes, we insert wire with regular ballon 2 or 2.5 in the aorta after that inflate ballon. This helps stability guide and easier position stent in the ostium and inflated stent precise at ostium.

[Yurii Melen @MelenYurii]

@SaidAshrafMD It's a great technique, but in the ostial lesion, we are using wire with a ballon floating technique. This technique helps stabilize guide catheters and help us easily place stent in the ostium .

[Yurii Melen @MelenYurii]

@DrIHHashmi1 Adequately predilatetion Diagonal brunch , with available ffr wire in the lad for right mesuarment significant lesion lad, and if ffr positive than to do cullotte or dk crush ( dicesion depends from operator), if ffr negative than try to do inverted t-provisional

[Yurii Melen @MelenYurii]

@evandrofilhobr Do you think about antegrede strategy recanalization cto?

[Yurii Melen @MelenYurii]

Strategy pci after predilatetion on both branches, I got dissection in them, I did dk crush, only one way to get out of this situation with safe of two branches

[Yurii Melen @MelenYurii]

@Hragy Thank you for your comment . I did exactly how you recommended and got dissection in both branches. After that, the strategy pci was only a one-dk crush , what I did.

[Yurii Melen @MelenYurii]

Male 67 year old, with typical angina non-stemi, high elaveted troponin, ECG (-) T wave V1-V6. On angiogram stenosis LAD-D2 (Medina 1,1,1). What strategy do you chose for PCI ( one or two stent) and which technique (provisional, cullote or dk crush)?

[Yurii Melen @MelenYurii]

@Hragy Full agree, but our health care system doesn't reimburse ivus, but patients with acs, than will you do pci without add imaging ivus

[Yurii Melen @MelenYurii]

Male 50 year old, on the diagnostic coronarography, we find one take-off for both coronary arteries. What is the best strategy PCI or Cabg? When will you do pci? What is best add imaging(ivus or ffr/ifr)for measurement significant stenosis in the LM?

[Yurii Melen @MelenYurii]

@ColletCarlos @Steph_Achenbach @escardio @ziadalinyc @Drroxmehran @JEscaned @mirvatalasnag @M_Marwan_ @HolgerNef @thiele_holger @tommasoggori This discordant beetwen iFr-/FFR+ is meaned that CFR more than 2, if this true, this cohort patients have similar outcomes as iFr-and FFR -. Could Carlos explain this? Thank you

[Yurii Melen @MelenYurii]

@ColletCarlos @wfearonmd @JEscaned @Hragy Carlos thank you for sharing case, it's very interesting, what do you think if is stenotic lesion proximal to the myocardial bridge, what physiology index (ifr or ffr) is the most appropriate and accurate for evaluation this lesion ?

[Yurii Melen @MelenYurii]

@jorgeachv @Dutra_1982 @BifurcationClub @latambifclub @OjedaOjeda18 @MPAOSS @mmamas1973 @adrianocaixeta @mirvatalasnag @CiticMexico @SOLACI3 @mornei2011 @HugoAlvaradoMo3 @DOI Wire entrapment before or after POT

[Yurii Melen @MelenYurii]

How do you treat this lesion. Who does using IVUS before treating this lesions ?

[Yurii Melen @MelenYurii]

@hsuradi Which size burr did you use, and size burr does matter ?

[Yurii Melen @MelenYurii]

@monaltiren @PeterKayaert @panosxap @Sofiegevaert @JoelleKefer Thanks for sharing, very interesting article