Pursue Classics·Originality - Gusta® Balloon Seminar Salon：Beijing Station

Pursue Classics·Originality - Gusta® Balloon Seminar Salon：Beijing Station

Demax April 22, 2022 

 

 

 

Preface|Academic Circles without Borders

From the first treatment of balloon dilation of coronary heart disease in 1977 to now, the coronary artery intervention therapy has developed for more than forty years. During the forty years, interventional treatment methods have changed rapidly, and countless domestic and foreign interventional physicians have been adhering to the spirit of craftsmanship to constantly explore, thus creating a new era after another.

However, there are many challenges and problems to be solved in the field of PCI. Demax adheres to the concept of “Academic Circles without Borders” and is willing to build a bridge for international communication. It is expected that domestic and foreign experts can hold dialogue and deepen cooperation to explore new technologies and make new breakthroughs.

On April 7, Demax invited experts from many domestic hospitals to discuss the wonderful cases of interventional treatment of coronary artery disease, and shared the whole process with foreign experts and scholars via stream.

 

 

During the seminar, we invited Professor Chen Hui from Beijing Friendship Hospital Affiliated to Capital Medical University, Professor Liu Wei from Beijing Jishuitan Hospital, Professor Guo Jincheng from Beijing Luhe Hospital Affiliated to Capital Medical University, Professor Ren Fengxue from Aviation General Hospital of China Medical University, Professor Xue Yajun from Beijing Tingshua Changgung Hospital Affiliated to Tsinghua University, Director Fan Jun from Beijing Jishuitan Hospital, Professor Zhao Likun from China Aerospace Science and Industry Corporation 731 Hospital, Director Gong Xuhe of Beijing Friendship Hospital Affiliated to Capital Medical University, and Physician Cui Hehe from Beijing Friendship Hospital Affiliated to Capital Medical University.

Meanwhile, four foreign experts were invited:

Dr. FRANCO DE REMIGIS (Italy)

Dr. LIVIO GIULIAN (Italy)

Ahmed Abdellatif (Egypt)

Mohammed Alqahtani (Saudi Arabia)

To discuss and explore new ideas of intervention with us.

Guest Discussion|New Insights New Ideas

 

Cui Hehe: Gusta^® Balloon Assisted LCX-CTO Interventional Treatment of Bifurcation Lesions

Beijing Friendship Hospital Affiliated to Capital Medical University

A male patient, 55 years old, with intermittent chest tightness for 5 years was admitted to the hospital. The admission diagnosis result showed coronary atherosclerotic heart disease, unstable angina pectoris, hyperlipidemia, type 2 diabetes, type 2 diabetic peripheral neuropathy and old cerebral infarction and many other diseases.

When performing the coronary arteriography, it showed that there was 30%-50% stenosis in anterior descending branch, 100% occlusion of the distal circumflex branch, 70%-90% stenosis at the opening of OM1, and 70%-80% stenosis at the opening of the intermediate branch. The bifurcation of small blood vessels in the distal segment of the right coronary involved severe stenosis in PDA and PLA and the patient’s symptoms were more obvious, so the hospital decided to actively perform the intervention treatment.

The circumflex branch CTO was opened first, the guide wire was sent to OM1, and Gusta^® 1.5*15 mm balloon was applied to fully expand the occluded segment, and then the 2.0 mm and 2.5 mm balloons and spinous process balloons were used to continue the dilation. Due to the long stenotic vessel, the drug balloon program was abandoned after full consideration, and a stent was implanted at the lesion part for full dilation.

Then the opening of OM1 was treated, and a small Gusta^® 1.25*15 mm balloon was applied to pass through the mesh of the stent and was used together with a 2.0 balloon to expand the opening, and then the Gusta^® NC 2.5*15 mm was used for kissing in the stent, and finally the stent was fully dilated and the OM1 opening was significantly relieved.

The posterior descending branch of the right coronary artery was treated and a 2.0*15 mm balloon and a spinous process balloon were used first for pre-dilation and then a 2.5*30 mm drug balloon was used for treatment and the vascular condition was fully relieved.

The surgeon said that the Gusta^® balloon played a good role in the treatment of small vessel lesions, CTO opening, kissing dilation after stent placement, and stent mesh penetration.

Professor Guo Jincheng and Professor Ren Fengxue affirmed the standardization of surgical operations, and pointed out that for complex cases of cardiovascular disease complicated with diabetes mellitus and cerebrovascular disease, special attention should be paid to the ischemia and bleeding risk assessment before surgery, and intracavitary imaging should be combined to perform the operation with caution during surgery.

Meanwhile, two experts discussed the criteria for evaluating the pros and cons of the balloon: the first is the passability, the second is whether the problem of holding the guide wire occurs after reaching the rated burst pressure, and the third is whether repeated dilation is allowed. Experts believe that Gusta^® series balloons have better performance in the above three aspects.

Professor Liu Wei also pointed out that the circumflex branch was tortuous, the load was heavy, and placement of stent would easily cause hematoma so that special caution should be paid during the operation.

 

Fan Jun: Treatment of Left Main Coronary Artery Bifurcation Lesions under Rotational Atherectomy and Guidance of IVUS

Beijing Jishuitan Hospital

A male patient, 70 years old, often suffers from chest tightness during activities. The symptoms appear when he walks about 200 meters on flat ground, and can be relieved after resting for a few minutes.

Coronary angiography showed obvious calcification in the left main trunk and the proximal and middle segments of the anterior descending branch, severe stenosis of the openings of the anterior descending, circumflex, and diagonal branches, and occlusion of the middle and distal segments of the circumflex; diffuse plaque infiltration in the right coronary artery without severe stenosis.

In terms of the selection of surgical strategy, due to the severe calcification and severe stenosis of the left main trunk, it is considered that the treatment is difficult. And opening the distal segment of the circumflex branch first may cause damage to the left main trunk, and the distal segment of the circumflex branch is not an important blood vessel, without large necessity. After thinking over and over again, we decided to give up the opening of the circumflex branch and give priority to the treatment of the left main trunk.

The distal radial artery approach was taken. Firstly, use Gusta^® 2.0 mm balloon to dilate the circumflex artery and the anterior descending artery. IVUS showed 270° annular calcification and the blood vessel diameter stenosis. After 2-3 times of active rotational atherectomy, it entered the distal segment of the anterior descending artery. Gusta^® 2.0*15 mm and Gusta^® 2.5*15 mm balloons and cutting balloons were used to pre-dilate and cut the lesions of the anterior descending and circumflex branches, and the angiography showed that the stenosis was relieved. A stent was implanted in the distal segment of the anterior descending artery.

The anterior trigeminal of the left main trunk was treated and a 3.0*13 mm stent was implanted in the left main trunk, and a 3.5*23 mm stent was implanted in the anterior descending branch to the left main trunk. IVUS showed that the stent adhered well, with satisfactory results.

Professor Xue Yajun and Professor Chen Hui believed that this case was complex, with high degree of difficulty, and the operation process was complete and exciting, which was worth learning.

Professor Xue agreed with the strategy of not opening the distal circumflex branch based on the patient’s condition. Director Chen Hui also pointed out that intracavitary imaging is worthy of wide application, which is of great significance for evaluating the surgical strategy of the bifurcation point.

 

Gong Xuhe: Treatment Case of Adequate Pre-dilation Balloon for Coronary Multivessel Disease

Beijing Friendship Hospital Affiliated to Capital Medical University

 

 

A male patient, 67 years old, with exertional angina pectoris for 3 weeks was admitted to the hospital and diagnosed with coronary heart disease, unstable angina pectoris and risk factors such as hypertension, hyperlipidemia and diabetes.

Angiography was performed which showed subtotal occlusion of the distal segment of the circumflex branch, severe stenosis in the proximal segment of the intermediate branch; diffuse calcification in the proximal and middle segments of the right coronary artery, severe stenosis in the proximal segment of the PDA. Staged intervention was considered to treat the right coronary artery first.

The right coronary artery was dilated with a 2.0*15 mm balloon, a 3.5*30 mm stent was implanted in the middle section, and a 3.5*22 mm stent was implanted in the distal section, and the stent dilation was completed after implantation. A small balloon was used to dilate PDA to improve the stenosis.

The left coronary artery was treated two days later. Firstly, the circumflex branch was dilated with Gusta^® 1.5*10 mm balloon, followed by 2.0*10 mm cutting balloon, and 2.5*13 mm balloon for further dilation, and the angiographic display effect met the expectation. In line with the concept of intervention without implantation, a drug balloon was placed for treatment.

The circumflex and intermediate branches were repeatedly applied with Gusta^® 1.5*10 mm balloon, followed by 2.0*10 mm cutting balloon, and the 2.5*13 mm balloon was used for further dilation. Upon confirmation of the effect through angiography, drug balls were applied to the circumflex and intermediate branches respectively. The operation was completed with satisfactory results.

Professor Zhao Likun and Professor Liu Wei recognized the good passability and flexibility of the Gusta^® balloon during the operation, and emphasized that attention shall be paid to the antithrombotic treatment of the patient after the use of the drug ball.

During Q&A activities, the product manager of Demax explained the product name of Gusta^®: Gusta, which means breeze, gentle. The company hopes that Gusta^® balloon can treat diseased blood vessels as gently as a breeze, so as to better cure the patients.

 

 

Professor Chen Hui made a conclusion and thanked all the guests from home and abroad. He pointed out that with the improvement of domestic balloon technology in recent years, comprehensive sizes of the balloons become available gradually. In particular, the breakthrough of small balloon technology has helped the treatment of complex lesions. After the national centralized collection, the cost performance of domestic balloons has gradually improved, thus providing more choices for surgeons.

Demax is also encouraged. In the future, we will continue to improve the original process technology, and we also look forward to building more technical exchanges for domestic and foreign experts in the field of interventional cardiology. Looking forward to the next summit dialogue between Chinese and international experts!

To learn more about Demax Medical, please visit: https://www.demax.group/