Dr. Jimmy Kerrigan, IC from Ascension St. Thomas West Hospital in Nashville TN, utilizes his always available tools of IVUS and Co-registration in most of his PCIs. Here he summarizes his workflow and protocol of pre- stent vessel assessment using IVUS and IVUS co-registration as well as his procedural guidance from the ULTIMATE criteria as he optimizes the stent to improve his patients acute and long-term outcomes.
we sat down with dr kerrigan to hear his step by step workflow and using IV's and co registration to better understand lesions, plan out a strategy and optimize the treatment to achieve the best outcomes he can for his patients. Dr kerrigan I'll run the eagle eye down to the area of concern. I'll start recording with my sync turned on. Um I find a spot where the distal lumen has less than 50% Blackbeard and I'll start my calculation there and with co registration I'll calculate the length of the stent at that point. Look for calcium which is going to inform my decision as to whether or not I need to go in with something like an angio spoked or a directory devices in order to modify the lesion to ensure that my extent is well expanded And from a practical standpoint usually if it's not 270° with more, I'll go in with a high pressure balloon and make sure that it expands. And so I'll press forward. If not, then we have to talk about a threat to me options at that point And then I'll find a spot approximately when possible that has less than 50% plaque burden so that I know that's where my proximal spent is. And with sync vision I can scroll through find that spot on the angiogram and not have to guess as to what my landmarks would be in order to achieve those outcomes. So deploy the stent post dilate with a high pressure balloon and the ultimate trial everyone got a balloon dilated to 18 atmospheres. Once I've achieved that, I'll put the ivy's back down. So again put the eagle eye distal to the, to the stent and make sure that I was right. My distal spent landed in a good spot. It's less than 50% Blackburn distantly and proximately. I'll find the smallest part of the stent and calculate the minimal stent area, making sure that that is bigger than the physical reference of lieutenant or at least 90% of it. If not bigger usually or at least greater than five square millimeters. Uh sometimes again with smaller vessels with might as well. And then making sure that there's no education section. So I try to put into practice what I teach colleagues and fellows. I try to as I said use this 100% of the time because I truly believe that it matters and we'll go through some of the data that shows that thanks dr kerrigan for this insightful. Look into your Pc. I. Experience and protocol. If you are interested in learning more from dr kerrigan or other Philips ivy's trainers, please reach out to your local phillips, coronary device representative or click on the training center's tab at the top of this page to view some of our key training partners