How to do dk crush
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The document outlines the dk-crush technique for stenting complex bifurcation lesions in coronary arteries, emphasizing key steps such as wiring, balloon inflation, and optimal stenting strategies for both the main vessel and side branch. It underscores the importance of careful rewiring and the use of non-compliant balloons for effective stent deployment and achieving optimal angiographic results. Furthermore, proximal optimization techniques are highlighted as crucial for improving stent apposition and mitigating potential complications.
How to do dk crush
- 1. How to do DK-Crush THE SUCCESSFUL STENTING STRATEGY FOR DISTAL LEFT MAIN
- 2. Abstract ā¢ Stratification of a given bifurcation lesion ā¢ The double kissing (DK) crush technique is better for complex coronary bifurcation ā¢ Stenting the side branch (SB) ā¢ Balloon crush ā¢ First kissing ā¢ Stenting the main vessel (MV) ā¢ 2nd kissing balloon inflation ā¢ Careful rewiring from the proximal cell of the MV stent to make sure the wire is in the true lumen of the SB stent is key to acquiring optimal angiographic results ā¢ Balloon anchoring from the MV ā¢ Alternative inflation and each kissing inflation using large enough non-compliant balloons at high pressure ā¢ Proximal optimisation technique are mandatory to improve both angiographic and clinical
- 3. Medina 1.1.1
- 4. Wiring SB
- 9. TAKING A BALLOON IN THE MAIN VESSEL FOR CRUSING SIDE BRANCH STENT
- 10. REMOVED SIDE BRANCH STENT BALLOON
- 11. CRUSING SIDE BRANCH STENT
- 12. PROPER CRUSING OF SIDE BRANCH STENT
- 13. FIRST KISSING
- 14. MV STENTING
- 15. POT
- 17. PREPARING FOR 2ND KISS
- 18. 2ND KISS
- 20. FINAL RESULT
- 21. Final result without wire
- 22. Through the lumen (OCT)
- 23. Summery ā¢ A) One balloon was introduced into the MV and the SB stent. B) & C) The balloon in the MV was then inflated to crush the SB stent after its deployment. D) After rewiring the SB proximally, a first kissing was performed. E) Stenting the MV. F) & G) Final kissing balloon inflation was conducted after rewiring the SB from the proximal MV stent cell. H) & I) After stenting both the MV and the SB, the proximal optimisation technique (POT) should be performed to improve MV stent strut apposition
- 24. Damage by distal strut wiring of MV before 2nd KISS ā¢ A) Position of MV and SB stents. B) SB stent deployment. C) MV stent deployment to crush the SB stent. D) Gap formation near the carina. E) Distal SB re- crossing, wire going between the SB stent and vessel wall. F) Final kissing balloon inflation. G) & H) Leaving a significant gap near the carina