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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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Coronary slow flow is not diagnostic of microvascular dysfunction in patients with angina and unobstructed coronary arteries. Coronary physiology interrogation has debunked one of the fallacies of the last decades.

Coronary slow flow is not diagnostic of microvascular dysfunction in patients with angina and unobstructed coronary arteries. Coronary physiology interrogation has debunked one of the fallacies of the last decades.

13,593 views

You have to treat this 👇🏻 circumflex #CTO. Ambiguous proximal cap, ipsilateral epicardial collaterals from diagonal. What’s your strategy?

You have to treat this 👇🏻 circumflex #CTO. Ambiguous proximal cap, ipsilateral epicardial collaterals from diagonal. What’s your strategy?

15,666 views

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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.
1:29
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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 Azzalini

38,045 views • 3 years ago

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
1:32
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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 Azzalini

13,954 views • 1 year ago

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. 🥵
1:38
LAzzaliniMD's profile picture

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 Azzalini

12,544 views • 1 year ago

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]).
1:57
LAzzaliniMD's profile picture

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 Azzalini

21,062 views • 3 years ago

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
1:42
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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 Azzalini

10,201 views • 1 year ago

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).
0:50
LAzzaliniMD's profile picture

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 Azzalini

11,492 views • 3 years ago

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