Bifurcation Lesion by Transradial Approach Dr. Sakhov Orazbek Chief of Cath Lab, City Cardiology center of Almaty, Kazakhstan
Republic of Kazakhstan Capital – Astana Population – Area km² Population density – 6 pers./km²
Surgical activity of interventional cardiologists of Kazakhstan
Surgical activity of interventional cardiologists of City Cardiology Center (Almaty)
Our consultants in the development of interventional cardiology Bernhard Reimers - Head of Cardiology, General Hospital, Mirano, Italy Jan Kovach - Consultant Cardiologist, University Hospitals NHS Trust Leicester, United Kingdom Ladislav Groch - assistant professor, Masaryk University, Faculty of Medicine, Brno, Czech Republic Sinitsa Stojkovich - Head, Department of Interventional Cardiology, Department of Cardiologzy, Clinical center of Serbia and others
Bifurcation Lesion by Transradial Approach with the support of Dr. Bernhard Reimers Patient T., male, 62 y.o. D-s: Non STEMI Risk-factors: Hypertension, current smoker Chest pain for 12 hours. ECG: negative T V2-V5 Echo: hypokinesia of anterior wall, EF – 49% Lab: troponin T – 0,22; myoglobin – 214,0
What to do? 1. CABG (before - maybe, but not now, with the support of high experienced colleagues) 2. Transition to transfemoral access (7-8 Fr guide, Crush, Mini Crush, Culotte, SKS) 3. Stay transradial access, Provisional stenting 4. Other
Take Home Message Transition to the treatment of bifurcation stenosis - a mandatory part of the work For most of bifurcation lesions – Keep it simple. For bifurcation lesions by transradial approach - Keep it more simple.