Accurate directional coronary atherectomy procedure using the tip detection method and intelligent 3D wiring pro software

Excerpt

During directional coronary atherectomy (DCA) (NIPRO, Osaka, Japan), it is crucial to observe the target lesion from the optimal angiographic direction with the least shortening and from which the side branches around the target lesion are clearly visible, and to transfer 3-dimensional information of plaque distribution on intravascular ultrasound (IVUS) images to angiographic images in the optimal angiographic direction. The latter is possible using the tip detection method, because it can be performed just before the lesion in the optimal angiographic direction for the DCA procedure unlike traditional methods which cannot always be done where there is the lesion [1]; however, the former has not been reported. We examined the optimal angiographic direction using Intelligent 3D Wiring Pro software™ (Trinity Co, Ltd, Osaka, Japan) developed by Koyama at our hospital for chronic total occlusion intervention. This software uses cardiac computed tomography images to display the angiographically orthogonal observation plane of any part of the coronary artery. From this plane, it is possible to visually identify the angiographic observational direction at which the side branches around the plaque are clearly visible. …