Left EBU/CLS guides manipulations, radial and femoral +Ikari L +Key tips in left coronary engagement

0:00 General LCA engagement steps: 1,2,3A and 3B. The JUMP, deep breath
06:57 Troubleshooting of a down pointing catheter (4 options). Deep breath
14:17 EBU/XB/CLS and Ikari L shapes, properties, and sizing from radial vs femoral. Above vs below engagement. Summary slide of all sizes/configurations 25:30
26:51 Maneuvers to engage EBU/CLS from radial (3B and 3C)
36:24 Maneuvers to engage EBU/CLS from femoral (3A and 3D)
38:35 Maneuvers to engage Ikari L vs EBU (+24:44)
39:41 Case illustrations
49:00 Don’t forget AL for LCA. Size for LCx vs LAD
50:37 Separate LAD-LCx ostia: 5 options to move from LAD to LCx and vice versa

[@AshokKumar-dn5tu]

Great presentation as usual sir, thanks a lot.

[@Nikesnipe]

Thanks a Million times

[@harshkumar1078]

Another great lecture... Sir please give talk on CTO

[@paulinbill1568]

Practical presentation 👍👍

[@Mohamed-cz7kc]

Thank you ❤sir

[@tahersalman6698]

Brilliant

[@mohamedfarouk1974]

Thank u prof

[@rohinsaini4]

Wonderful talk sir!!Can you please give a talk on CTOs

[@canramazanoncel5682]

👏🏻👏🏻👏🏻👍🏻

[@user-gn4iu8rd6i]

Thank you sir for your impressive talk. I have an issue cropping nowadays. For many years I have been using the JL and JR for diagnostic without any issue. I just changed working hospital where they use TIG mainly and I'm having lots of problems for diagnostic angiography.Any tips or advise you can give please.

[@eliashanna8248]

The main issue is that Tiger is a Tiger 4, ie, it has a long arm of 4 cm, frequently suboptimal radially for LCA. JL 3.5 is my preferred LCA diagnostic catheter radially, and I reserve JL4 for large aorta. The issue you are having is the issue I explain under 06:57 : the Tiger arm is long and its tip frequently points down below the coronary ostium. As I explained, there are 4 ways of fixing it: use deep breath to push the left main down (quickly advance your catheter during deep breath), or pull up with steep clock torque, or engage from below (3B). The best option is, however, to use a 3.5 arm catheter: just use JL 3.5. Tiger does not come in 3.5 length, but its cousin, Jacky catheter, is available in 3.5 and you may try that one as an alternative.

[@obscuraterror1891]

❤thanx