Thoracic Key

13.1 When to do coronary intravascular imaging? Coronary intravascular imaging can be performed before, during, and after PCI to determine the need for coronary revascularization, and help plan and optimize…

CTO Manual Online cases: 6 , 19 , 103 PCI Manual Online cases: 4 , 9 , 11 , 14 , 19 , 27 , 31 , 35 , 40…

11.1 Femoral access 11.1.1 Femoral access closure algorithm The following algorithm ( Fig. 11.1 ) reflects the experience and current practice of the authors; other vascular closure devices can be…

12.1 When should coronary physiology be used? 12.1.1 Before PCI 1. Determine significance of intermediate coronary lesions. Several studies have shown that PCI of lesions with adenosine fractional flow reserve…

Goal : To deliver and adequately expand a stent, completely covering the target lesion. 10.1 When to stent? Stenting (in most cases with drug-eluting stents [DES]) is performed in the…

4.1 Choosing access site Obtaining arterial access is required for performing diagnostic coronary angiography and percutaneous coronary intervention (PCI). There is continued controversy about optimal access site selection. Radial (proximal…

In Chapter 4 , Access, we discussed about how to obtain arterial access. In this chapter we describe the steps involved in advancing a catheter over a guidewire from the…

Goal : To advance a guidewire through and distal to the target coronary lesion in the most efficient way and without causing a complication and to provide an adequate platform…

Although adjunctive modalities (stress testing, noninvasive imaging including coronary computed angiography, coronary physiology, and intracoronary imaging) can help evaluate coronary anatomy, coronary angiography remains the most commonly used technique for…

The following decisions need to be made after coronary angiography is performed. 1. Is coronary revascularization needed? Like every other procedure, coronary revascularization should be done when the anticipated benefits…