My observations
1. Since LCX is a dominant vessel , park ur wire way deeper into the LCX into LPDA , it wud have been much easier
, there is a basic principle here "ARCHIMEDES LEVEL MECHANICS" principle of fulcrum ..
Deeper the wire parked longer is the fulcrum arm at the resistance zone ( i.e the lcx ostium ) amplifying torque and force transmission => easier directional push => easier crossing ..
BASILICA and LAMPOON in action ⚡
Adam Greenbaum demonstrates how fluoroscopy and TEE confirm perpendicular catheter alignment before leaflet incision. Off-centre cuts risk incomplete modification.
Energy at 70 W with continuous flush ensures controlled traversal.
A clear
“Mother Infant” technique. 4 French pigtail inside a 6 French XBLAD 3.0 to prevent “razor effect” in a patient with NSTEMI
sciencedirect.com/science/articl…
An overhanging stent is difficult to deal with. Here’s a solution: Remove it and start fresh. This is one of few cases we’ve done at Henry Ford Hospital. All successful, no adverse events.
doi.org/10.1016/j.jacc…@HenryFordHealth @hfhcardiofellow @JACCJournals@KAlaswadMD
@realarainmd this is a common scenario observed in DK crush during second recross especially in heavily calcified and angulated LMs. Before going for anchor balloon 🎈/ guide extention, stent ablation we do confirm our wire position in LM with the imaging to prevent LM stent deformation in case of abluminal wiring. Here is our published modified DKC to improve SB outcomes jacc.org/doi/10.1016/j.…
What Is Going On Here?!
IYKYK. All the information you need is in this clip. 😀
Extra points if you can describe the sequence of events leading up to this point.
Share your thoughts below. I will ‘divulge’ the answer later today.
In STEMI complicated by cardiogenic shock, timing may extend beyond reperfusion alone. In this nationwide registry, earlier left ventricular unloading with a microaxial flow pump was associated with lower in-hospital mortality, suggesting that "door-to-unload" time may emerge as an important metric in shock care.
🔗eurointervention.pcronline.com/article/door-t…#STEMI#CardiogenicShock#Impella
☝️PCSK9 Inhibitors & Lp(a): Beyond LDL-C Lowering
1️⃣ Evolocumab consistently reduces Lp(a) by ~20–25%, in addition to producing profound LDL-C reductions of approximately 60% across multiple clinical trials.
2️⃣ The magnitude of Lp(a) lowering correlates with LDL-C reduction, suggesting a shared biological pathway influenced by PCSK9 inhibition.
3️⃣ Patients achieving very low LDL-C (<40 mg/dL) experience greater Lp(a) reductions, supporting the concept that reduced LDL competition enhances Lp(a) clearance.
4️⃣ Experimental data indicate that Lp(a) can interact with the LDL receptor (LDLR), although with lower affinity than LDL. Increasing LDLR expression enhances Lp(a) uptake, while PCSK9 inhibition appears to facilitate this process.
👉These findings support the hypothesis that LDLR-mediated clearance contributes to Lp(a) reduction with PCSK9 inhibitors, providing a mechanistic explanation for a clinical observation that had long remained unclear.
🔗🔓 jlr.org/article/S0022-…@society_eas@nationallipid
The roadmap to #SEOULVALVES2026 is now revealed! Explore the full program and discover a dynamic lineup of faculty, live cases, case presentations, and much more! Plan your journey now and uncover the sessions that will define your experience in Seoul.
🔗seoul-valves.com/2026/program_g…
What Is Going On Here?!
IYKYK. All the information you need is in this clip. 😀
Extra points if you can describe the sequence of events leading up to this point.
Share your thoughts below. I will ‘divulge’ the answer later today.
Transcatheter papillary muscle approximation (or "percutaneous papillary muscle banding") targets left ventricular geometry rather than contractility. A 58-year-old man with advanced ischaemic heart failure and a severely dilated, spherical left ventricle due to adverse remodelling underwent first-in-human implantation using the VSling system. Via transfemoral access, a steerable catheter encircled both papillary muscles and deployed an adjustable band, reducing interpapillary distance from 27 to 12 mm. eurointervention.pcronline.com/article/transc…
Probably one of the most rewarding cases that I had joined, invite you to read!
Now published in JACC Case Reports!
First IVUS-guided CTO recanalization in a pediatric patient with pseudoxanthoma elasticum.
interestingly intravascular imaging was used to recanalize and guide a vessel-preserving DCB strategy in a 14-year-old girl.
sciencedirect.com/science/articl…#CTO#IVUS#PXE#InterventionalCardiology#DCB
An unconventional pathway to the management of an iatrogenic dissection
🔗pcronline.com/Cases-resource…
Iatrogenic coronary dissection is a rare but potentially life-threatening complication of PCI, resulting in flow loss, chest pain, and ST-segment elevation.
View part 1⃣ of this case by @pabl0salinas : with conventional wiring strategies proving unsuccessful, what would be the next step?
#interventionalcardiology#CardioEd
#CTO#PCI skills can help you in a multitude of situations as well!
An older patient (80s) presented with NSTEMI and cardiogenic shock, surgical turndown with trifurcation LM disease and ostial LAD CTO.
Impella support; LAD identified with #HDR and crossed; followed by DK crush
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