MSCT integration for complex bifurcation Alice Ohanessian MC Morice, T. Lefevre, Y.Louvard ICPS,...
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Transcript of MSCT integration for complex bifurcation Alice Ohanessian MC Morice, T. Lefevre, Y.Louvard ICPS,...
![Page 1: MSCT integration for complex bifurcation Alice Ohanessian MC Morice, T. Lefevre, Y.Louvard ICPS, Massy France Institut Cardiovasculaire Paris Sud.](https://reader035.fdocuments.us/reader035/viewer/2022062620/5519d32a550346443e8b4b31/html5/thumbnails/1.jpg)
MSCT integration for complex bifurcation
Alice OhanessianMC Morice, T. Lefevre, Y.Louvard
ICPS, Massy France
Institut Cardiovasculaire Paris Sud
![Page 2: MSCT integration for complex bifurcation Alice Ohanessian MC Morice, T. Lefevre, Y.Louvard ICPS, Massy France Institut Cardiovasculaire Paris Sud.](https://reader035.fdocuments.us/reader035/viewer/2022062620/5519d32a550346443e8b4b31/html5/thumbnails/2.jpg)
CT integration for bifurcationbackground
• Tremendous improvement of Cardiac CT
• 64 slices CT
• Incredible perspectives
• New tool for facilitated coronary angioplasty ?
Institut Cardiovasculaire Paris Sud
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CT integration for bifurcationhow ?
• New concept developped by manufacturers
• One or two screens dedicated to CT integrated in the cath lab
• Screens directely connected to a CT work station outside the cath lab
Institut Cardiovasculaire Paris Sud
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CT integration for bifurcationhow does it work ?
• Cardiac CT is first performed in scan unit
• Images are post treated like usually
• Selected phases and images are then transfered to the CT work station in the cath lab unit
Institut Cardiovasculaire Paris Sud
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1. From the CT work station
2. From the cath lab
Institut Cardiovasculaire Paris Sud
CT integration for bifurcationwhat can we do ?
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CT integration for bifurcation 1. from the CT work station
Institut Cardiovasculaire Paris Sud
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CT integration for bifurcation 1. from the CT work station
• Coronary tree reconstruction
• select cardiac CT images
• define optimal view to display the lesion and plaque extension
• select the best angle to work during PCI
Institut Cardiovasculaire Paris Sud
![Page 8: MSCT integration for complex bifurcation Alice Ohanessian MC Morice, T. Lefevre, Y.Louvard ICPS, Massy France Institut Cardiovasculaire Paris Sud.](https://reader035.fdocuments.us/reader035/viewer/2022062620/5519d32a550346443e8b4b31/html5/thumbnails/8.jpg)
CT integration for bifurcation 1. from the CT work station
• Mesure the true lesion length
• Appreciate the true shortening
• Plaque extension
• Anatomic relation with side branch
• Ostial lesion of side branch (bifurcation)
Institut Cardiovasculaire Paris Sud
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CT integration for bifurcation 2- from the cath lab
Institut Cardiovasculaire Paris Sud
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CT integration for bifurcation 2- from the cath lab
• Appreciate at the same time angiographic view and anatomic view
• Grant tube and CT images (3D, angio) synchronized
• Call the view previously selected • No wasted contrast media in choosing
the optimal view (tube rotation makes rotate CT view)
Institut Cardiovasculaire Paris Sud
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CT integration for bifurcationImprovement for opertor
• Save procedural time
• Select best view without contrast or scopie
• Less irradiation
• Optimize PCI strategy
• Increase procedural success in complex PCI and complex anatomy
Institut Cardiovasculaire Paris Sud
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CT integration for bifurcationimprovement for the patient
• Procedure is shorter
• Improve patient comfort
• Less contrast medium used
• Less renal failure
• Less irradiation: but MSCT irradiation
Institut Cardiovasculaire Paris Sud
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CT integration for bifurcationcomplex bifurcation: angio
Institut Cardiovasculaire Paris Sud
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CT integration for bifurcationcomplex bifurcation: MSCT
Institut Cardiovasculaire Paris Sud
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CT integration for bifurcationcomplex bifurcation: integration
Institut Cardiovasculaire Paris Sud
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CT integration for bifurcationPCI procedure
Institut Cardiovasculaire Paris Sud
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CT integration for bifurcation tube and 3D view synchronization
Institut Cardiovasculaire Paris Sud
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CT integration for bifurcationtrifurcation result
Institut Cardiovasculaire Paris Sud
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CT integration for bifurcationconclusion
• MSCT integration in the cath lab is a new tool
for interventional cardiologist
• Important improvement in the approach of
complex PCI
• Shorter procedure, less contrast media
• Reserved to complex cases
• Dose modulation +++(3-5msv)
Institut Cardiovasculaire Paris Sud