Case 131: PCI Manual - A great start!

[@fatherabdul]

Excellent Job Manos as always. ☕️☕️

[@jktg3049]

Can you explain what is and how to do "debranching"

[@MSK-s7w]

Amazing and great case !! We should always pay attention to pressure before injecting contrast.

[@shangz0216]

Thanks for the educative case sharing.

[@ramidudin1]

Thank you for share this case, I think conclusion to secure distal wire before any inflation balloon or sent. Another point I will stop and avoid further contrast injection to avoid dissection expanding to right coronary sinus and ascending aorta because patient stable and she has good collateral from left.

[@arminmarashizadeh5540]

Thank professor for your educative case as usual, can you explain more about debranching ? How did you reentered?

[@praveenalane4331]

Thanx for the case professor..what alternative wires do you suggest other than gladius for debranchibg in star approach ?

[@manosbrilakis]

Polymer jacketed guidewires, such as Fielder XT or Pilot 200.

[@denizaktürk-j7n]

Thank you very much for shareing this case. I would like to ask what if you had another complication at septal artery that was keeping the patient stable?

[@manosbrilakis]

A problem with a septal branch would likely not be a big problem, but compromising LAD flow could be fatal. Using a safety wire and meticulous attention to ACT and pressure waveform are important to prevent donor vessel injury/thrombosis.

[@denizaktürk-j7n]

@@manosbrilakis Thank you for your kind response. It is a great honor for me.