
Lorenzo Azzalini
@LAzzaliniMD • 6,278 subscribers
Interventional cardiologist @UWCathLab @UW @UWMedHeart. Director of Interventional Cardiology Research. Specialized in #CTO #CHIP #PCI.
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Would you open the LAD antegradely or via the LIMA? We chose the latter (long distance to drill & lack of dedicated material if antegradely). Advanced the burr slowly with no Dyna through mild tortuosity in LIMA. Still, LIMA got dissected, but were able to quickly fix everything.
Lorenzo Azzalini38,045 Aufrufe • vor 3 Jahren

First line #HDR (puncture with GN3, contrast 💦, then ‘no tip XT’ according to sacred scriptures 📖) ➡️ subintimal stain. I ask the HDR Oligarchs why it didn’t work ❓ (Then easy bailout retro, 1 stent, 🔪🎈 to decompress distal hematoma) Salman Arain Tsutomu Fujita MD Mauro Carlino
Lorenzo Azzalini13,954 Aufrufe • vor 1 Jahr

Yet again victims of the True Lumen Religion 📖. 3Dright to engage (🔝choice), crossing with 🐝 and 🗡️, then nothing would go (4 MCs, grenadoplasty, external crush 🗜️), free threw Rota wire, drilled ⛏️with 1.5 mm, still undilatable ⏳, first IVL 🎈💥, second does the job. 🥵
Lorenzo Azzalini12,544 Aufrufe • vor 1 Jahr

Ever drilled a septal to go retrograde? J-CTO 5, prior failed SPM. Uncrossable after surfing invisible septal. 1.5 mm burr + POBA of septal. Tip in into guide, then rendezvous into PDA to send ante wire up the LAD for added support (couldn’t externalize R350 [100 cm guide]).
Lorenzo Azzalini21,062 Aufrufe • vor 3 Jahren

Rota 1.5+2.0 burr to go retro via LAD for ostial RCA #CTO. Dilated septal. Complex reverse cart. Retro MC wouldn’t go into antegrade guide despite pinning. Tip in. Two antegrade MCs couldn’t cross over tipped-in wire. Rota 1.5 in extraplaque space. Retro crossing. 3 DES.MSA 6 mm2
Lorenzo Azzalini10,201 Aufrufe • vor 1 Jahr

Orbital #atherectomy @csi360 is a valuable option to treat recalcitrant, multilayer #ISR due to stent underexpansion. Here, where laser, cutting balloon and IVL had previously failed, OA allowed to reach a reasonable MSA, after ~7 minutes of orbiting (10 long runs).
Lorenzo Azzalini11,492 Aufrufe • vor 3 Jahren
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