Case 171: Manual of PCI - The uncrossable lesion

[@shangz0216]

Thanks for sharing.

[@deguzmanaaron]

What is grenadoplasty?

[@manosbrilakis]

Inflation of a small balloon (usually 1.5 - 2.0 mm) at high pressure until it ruptures. The rupture may modify the plaque and facilitate subsequent equipment advancement.

[@usetherightbrain.]

" You shall not Cross"--- Mano- "Oh, yes I will!"

[@denizaktürk-j7n]

What if atherectomy also failed?

[@manosbrilakis]

Options include laser, various plaque modification balloons, extraplaque wire crossing.

[@denizaktürk-j7n]

@@manosbrilakis Sir if we went from around the lumen and after ballooning and we faced a rupture? What will be our options. Graft stents would be hard to deliver.

[@manosbrilakis]

@@denizaktürk-j7n Good question: equipment delivery is much easier in the extraplaque (subintimal space). Balloon and stent sizing should be more conservative in the extraplaque space and high-pressure balloon inflations avoided.

[@denizaktürk-j7n]

@@manosbrilakis Thank you very much. I appreciate for your kind response

[@Abhix-x6z]

Change operator first.Doesn't look tough wiring

[@arun10430]

Typical Indian!