PCI of Long LAD CTO using Antegrade Approach

Case and Plan:
55-year-old male presented with new onset CCS Class II angina and known intermediate two vessel CAD from angiogram in 2018. A Cardiac Cath on August 13, 2024 revealed calcified 2 V CAD: 70-80% proximal-mid RCA, 80-90% prox LAD-D2 bifurcation with CTO of mid LAD (JCTO Score 4), SYNTAX Score of 26 and normal LVEF. Patient underwent FFR guided successful interventions of proximal and mid RCA using two Xience DES. Patient is now planned for staged PCI of long LAD CTO using antegrade approach guided by contralateral injection.

[@wilzboyz]

Unfortunately I believe you covered the LIMA landing site by stenting into the distal LAD. Inserting a LIMA distal to the stent would be of questionable benefit.

[@Docsammy]

Dr Sameer needs to have lesser verbal participation

[@JCT75]

Starts at 26.50

[@kjaulakh1]

There are CTOs and then there are CTOs.

[@siwanchoi9470]

Montone et al