Case 237: Manual of CTO PCI - Retrograde via an ipsilateral septal collateral
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- Опубликовано: 14 дек 2023
- A patient presented with exertional dyspnea and was found to have anterior ischemia and a mid LAD CTO. The LAD CTO had a blunt proximal cap with heavy calcification, short length, diseased distal vessel, and was filling via an epicardial collateral from an acute marginal and from a septal to septal collateral. An initial antegrade attempt failed due to inability to re-enter into the distal true lumen using the Stingray system. Repeat attempt 2 months later was done via the ipsilateral septal to septal collateral. Crossing attempts of the collateral with a Sion black wire resulted in perforation but repeat attempts with a Suoh 03 wire resulted in successful guidewire crossing. After reverse CART the retrograde wire was externalized, followed by antegrade wiring of the LAD using a Sasuke dual lumen microcatheter. After removing the retrograde wire the LAD was stented with an excellent final result.
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Thanks for the excellent case presentation.
Marvellous as usual
Excellent case demonstration. One correction higher the CC score - easy to cross the collaterals .
Great point, thank you!