Middle East Bifurcation Club-Middle East Bifurcation Club

Video Transcription

Video Summary

In this webinar of the Skype Bifurcation Club, hosted by Daniel Webb, several cardiologists from different regions, including the Middle East and the US, discussed advanced interventional cardiology techniques, focusing on complex bifurcation lesions. The session began with Dr. Mehrabat Al-Asnaf presenting on the importance of intravascular imaging in managing bifurcation lesions, particularly left-main bifurcations, using data from recent trials like the October trial. Key points included the use of OCT and IVUS in optimizing procedural outcomes by assessing lesion morphology, stent apposition, and expansion.<br /><br />Following the presentation, two complex case studies were showcased: <br /><br />1. Dr. Ziad Ghazal presented the case of an 89-year-old patient with multi-vessel coronary artery disease, a history of renal impairment, and reduced ejection fraction post-revascularization stage strategy using a balance of complex PCI techniques and conservative management. The case highlighted the use of different wiring techniques and drug-eluting stents, eventually stabilizing the patient's condition post-procedure despite initial complications.<br /><br />2. Dr. Fadi Sawaya detailed the management of an 84-year-old female with severe aortic stenosis and unstable coronary anatomy, showcasing a meticulous strategy involving rotablation and the use of drug-eluting balloons (DEB) in complex bifurcation lesions. This approach highlighted modern trends to simplify treatments by minimizing stent implantation and employing DEB to improve longer-term outcomes, particularly in difficult-to-treat areas like the osteal circumflex.<br /><br />Throughout the session, the panel emphasized strategies for complex cases, including the timing and sequence of interventions with associated risks, the decision-making process regarding surgical versus interventional approaches, and the role of novel technologies in enhancing procedural outcomes while managing patient-specific risks.

Keywords

interventional cardiology

bifurcation lesions

intravascular imaging

OCT

IVUS

drug-eluting stents

rotablation

drug-eluting balloons

coronary artery disease

aortic stenosis