SlideShare une entreprise Scribd logo
Angioplastie périphérique
par voie radiale
Déclaration	de	conflits	
d’intérêts
• Consultant	et	proctor:	Biotronik
• Consultant:	Boston
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
Introduction
88
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
Introduction
17
Introduction
• Voie	radiale:	plus	de	2/3	des	procédures	
coronaires	des	pays	européens
• Diminution	complications	hémorragiques		
• Confort
• Matériel	adapté	en	coronaire
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
Introduction
Voie	radiale	en	périphérique
– Absence	de	matériel	dédié	jusqu’à	peu!!!
– Allongement	de	la	distance	lésion	et	voie	d’abord
– +++	Si	indication	d’antérograde,si scarpa hostile	et	
obesité ou	si	cross	over	difficile
=>	Alternative	?
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
LES	DIFFERENTES	CIBLES
• RÉNALE
• AORTO-ILIAQUE
• FEMORO-POPLITE
• CAROTIDE
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
RÉNALE
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
RÉNALE
• Voie	d’abord	classique
• Coaxiale++
• Parfois	plus	facile	que	la	voie	fémorale
• Matériel	de	coronaire
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
27	patients….
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
rénale
JR4
0,14	BHW
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
rénale
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
rénale
rénale
Rénale/sheathless
Sheathless 7.5F	JR4	ASAHI;	Guide	0,14	BHW
RESTENOSE	INTRA-STENT
BALLON	ET	BALLON	ACTIF
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
FINAL
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
Ilio-fémoral
• Si	scarpa hostile+++
• Procédure	facile
• Moins	de	soucis	de	longueur..
• Interêt ++	si	double	atteinte	et	nécessité	double	
abord.
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
TRA:	65	patients
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
iliaque
120	cm
iliaque
Shaft:	180	cm
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
Voie	d’abord	fémorale	et	radial	G
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
Progression	du	stent sans	Kt guide
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
final
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
Abord	fémorale	x2	et	radiale	
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
Abord	fémorale	x2	et	radiale	
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
Abord	fémorale	x2	et	radiale	
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
Abord	fémorale	x2	et	radiale	
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
Double	abord	radial	et	poplité
deuxième	tentative
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
Double	abord	radial	et	poplité
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
Double	abord	radial	et	poplité
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
Résultat
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
carotide
• Peu	par	en	an	en	fémoral/	chirurgien
• Pas	via	l’approche	radiale
• Certaines	équipes:	oui++
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle
Conclusions
• Approche	radiale	est	possible
• Matériel	adapté
• Peu	de	complication
• Lésion	complexe:	plus	difficile
• Voie	supplémentaire
• Intérêt	et	développement	++++
25/11/2017 5ème Rencontre	Paramédicale	en	cardiologie	interventionnelle

Contenu connexe

En vedette

How to Prepare For a Successful Job Search for 2024
How to Prepare For a Successful Job Search for 2024How to Prepare For a Successful Job Search for 2024
How to Prepare For a Successful Job Search for 2024
Albert Qian
 
Social Media Marketing Trends 2024 // The Global Indie Insights
Social Media Marketing Trends 2024 // The Global Indie InsightsSocial Media Marketing Trends 2024 // The Global Indie Insights
Social Media Marketing Trends 2024 // The Global Indie Insights
Kurio // The Social Media Age(ncy)
 
Trends In Paid Search: Navigating The Digital Landscape In 2024
Trends In Paid Search: Navigating The Digital Landscape In 2024Trends In Paid Search: Navigating The Digital Landscape In 2024
Trends In Paid Search: Navigating The Digital Landscape In 2024
Search Engine Journal
 
5 Public speaking tips from TED - Visualized summary
5 Public speaking tips from TED - Visualized summary5 Public speaking tips from TED - Visualized summary
5 Public speaking tips from TED - Visualized summary
SpeakerHub
 
ChatGPT and the Future of Work - Clark Boyd
ChatGPT and the Future of Work - Clark Boyd ChatGPT and the Future of Work - Clark Boyd
ChatGPT and the Future of Work - Clark Boyd
Clark Boyd
 
Getting into the tech field. what next
Getting into the tech field. what next Getting into the tech field. what next
Getting into the tech field. what next
Tessa Mero
 
Google's Just Not That Into You: Understanding Core Updates & Search Intent
Google's Just Not That Into You: Understanding Core Updates & Search IntentGoogle's Just Not That Into You: Understanding Core Updates & Search Intent
Google's Just Not That Into You: Understanding Core Updates & Search Intent
Lily Ray
 
How to have difficult conversations
How to have difficult conversations How to have difficult conversations
How to have difficult conversations
Rajiv Jayarajah, MAppComm, ACC
 
Introduction to Data Science
Introduction to Data ScienceIntroduction to Data Science
Introduction to Data Science
Christy Abraham Joy
 
Time Management & Productivity - Best Practices
Time Management & Productivity -  Best PracticesTime Management & Productivity -  Best Practices
Time Management & Productivity - Best Practices
Vit Horky
 
The six step guide to practical project management
The six step guide to practical project managementThe six step guide to practical project management
The six step guide to practical project management
MindGenius
 
Beginners Guide to TikTok for Search - Rachel Pearson - We are Tilt __ Bright...
Beginners Guide to TikTok for Search - Rachel Pearson - We are Tilt __ Bright...Beginners Guide to TikTok for Search - Rachel Pearson - We are Tilt __ Bright...
Beginners Guide to TikTok for Search - Rachel Pearson - We are Tilt __ Bright...
RachelPearson36
 
Unlocking the Power of ChatGPT and AI in Testing - A Real-World Look, present...
Unlocking the Power of ChatGPT and AI in Testing - A Real-World Look, present...Unlocking the Power of ChatGPT and AI in Testing - A Real-World Look, present...
Unlocking the Power of ChatGPT and AI in Testing - A Real-World Look, present...
Applitools
 
12 Ways to Increase Your Influence at Work
12 Ways to Increase Your Influence at Work12 Ways to Increase Your Influence at Work
12 Ways to Increase Your Influence at Work
GetSmarter
 
ChatGPT webinar slides
ChatGPT webinar slidesChatGPT webinar slides
ChatGPT webinar slides
Alireza Esmikhani
 
More than Just Lines on a Map: Best Practices for U.S Bike Routes
More than Just Lines on a Map: Best Practices for U.S Bike RoutesMore than Just Lines on a Map: Best Practices for U.S Bike Routes
More than Just Lines on a Map: Best Practices for U.S Bike Routes
Project for Public Spaces & National Center for Biking and Walking
 
Ride the Storm: Navigating Through Unstable Periods / Katerina Rudko (Belka G...
Ride the Storm: Navigating Through Unstable Periods / Katerina Rudko (Belka G...Ride the Storm: Navigating Through Unstable Periods / Katerina Rudko (Belka G...
Ride the Storm: Navigating Through Unstable Periods / Katerina Rudko (Belka G...
DevGAMM Conference
 
Barbie - Brand Strategy Presentation
Barbie - Brand Strategy PresentationBarbie - Brand Strategy Presentation
Barbie - Brand Strategy Presentation
Erica Santiago
 
Good Stuff Happens in 1:1 Meetings: Why you need them and how to do them well
Good Stuff Happens in 1:1 Meetings: Why you need them and how to do them wellGood Stuff Happens in 1:1 Meetings: Why you need them and how to do them well
Good Stuff Happens in 1:1 Meetings: Why you need them and how to do them well
Saba Software
 
Introduction to C Programming Language
Introduction to C Programming LanguageIntroduction to C Programming Language
Introduction to C Programming Language
Simplilearn
 

En vedette (20)

How to Prepare For a Successful Job Search for 2024
How to Prepare For a Successful Job Search for 2024How to Prepare For a Successful Job Search for 2024
How to Prepare For a Successful Job Search for 2024
 
Social Media Marketing Trends 2024 // The Global Indie Insights
Social Media Marketing Trends 2024 // The Global Indie InsightsSocial Media Marketing Trends 2024 // The Global Indie Insights
Social Media Marketing Trends 2024 // The Global Indie Insights
 
Trends In Paid Search: Navigating The Digital Landscape In 2024
Trends In Paid Search: Navigating The Digital Landscape In 2024Trends In Paid Search: Navigating The Digital Landscape In 2024
Trends In Paid Search: Navigating The Digital Landscape In 2024
 
5 Public speaking tips from TED - Visualized summary
5 Public speaking tips from TED - Visualized summary5 Public speaking tips from TED - Visualized summary
5 Public speaking tips from TED - Visualized summary
 
ChatGPT and the Future of Work - Clark Boyd
ChatGPT and the Future of Work - Clark Boyd ChatGPT and the Future of Work - Clark Boyd
ChatGPT and the Future of Work - Clark Boyd
 
Getting into the tech field. what next
Getting into the tech field. what next Getting into the tech field. what next
Getting into the tech field. what next
 
Google's Just Not That Into You: Understanding Core Updates & Search Intent
Google's Just Not That Into You: Understanding Core Updates & Search IntentGoogle's Just Not That Into You: Understanding Core Updates & Search Intent
Google's Just Not That Into You: Understanding Core Updates & Search Intent
 
How to have difficult conversations
How to have difficult conversations How to have difficult conversations
How to have difficult conversations
 
Introduction to Data Science
Introduction to Data ScienceIntroduction to Data Science
Introduction to Data Science
 
Time Management & Productivity - Best Practices
Time Management & Productivity -  Best PracticesTime Management & Productivity -  Best Practices
Time Management & Productivity - Best Practices
 
The six step guide to practical project management
The six step guide to practical project managementThe six step guide to practical project management
The six step guide to practical project management
 
Beginners Guide to TikTok for Search - Rachel Pearson - We are Tilt __ Bright...
Beginners Guide to TikTok for Search - Rachel Pearson - We are Tilt __ Bright...Beginners Guide to TikTok for Search - Rachel Pearson - We are Tilt __ Bright...
Beginners Guide to TikTok for Search - Rachel Pearson - We are Tilt __ Bright...
 
Unlocking the Power of ChatGPT and AI in Testing - A Real-World Look, present...
Unlocking the Power of ChatGPT and AI in Testing - A Real-World Look, present...Unlocking the Power of ChatGPT and AI in Testing - A Real-World Look, present...
Unlocking the Power of ChatGPT and AI in Testing - A Real-World Look, present...
 
12 Ways to Increase Your Influence at Work
12 Ways to Increase Your Influence at Work12 Ways to Increase Your Influence at Work
12 Ways to Increase Your Influence at Work
 
ChatGPT webinar slides
ChatGPT webinar slidesChatGPT webinar slides
ChatGPT webinar slides
 
More than Just Lines on a Map: Best Practices for U.S Bike Routes
More than Just Lines on a Map: Best Practices for U.S Bike RoutesMore than Just Lines on a Map: Best Practices for U.S Bike Routes
More than Just Lines on a Map: Best Practices for U.S Bike Routes
 
Ride the Storm: Navigating Through Unstable Periods / Katerina Rudko (Belka G...
Ride the Storm: Navigating Through Unstable Periods / Katerina Rudko (Belka G...Ride the Storm: Navigating Through Unstable Periods / Katerina Rudko (Belka G...
Ride the Storm: Navigating Through Unstable Periods / Katerina Rudko (Belka G...
 
Barbie - Brand Strategy Presentation
Barbie - Brand Strategy PresentationBarbie - Brand Strategy Presentation
Barbie - Brand Strategy Presentation
 
Good Stuff Happens in 1:1 Meetings: Why you need them and how to do them well
Good Stuff Happens in 1:1 Meetings: Why you need them and how to do them wellGood Stuff Happens in 1:1 Meetings: Why you need them and how to do them well
Good Stuff Happens in 1:1 Meetings: Why you need them and how to do them well
 
Introduction to C Programming Language
Introduction to C Programming LanguageIntroduction to C Programming Language
Introduction to C Programming Language
 

Angioplastie périphérique par voie radiale