Case 209: Manual of CTO PCI - Side BASE
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- Опубликовано: 16 фев 2023
- A patient was referred for PCI of an LAD CTO with an ambiguous proximal cap at the takeof of a septal. IVUS-guided antegrade puncture failed causing a small wire perforation. A balloon was inflated sealing the perforation. Retrograde via septal collaterals from the PDA and via an epicardial collateral from a diagonal failed. The side-BASE technique was used: a balloon was inflated partially inside the LAD and partially inside the diagonal and a knuckled Gladius Mongo wire was advanced extraplaque through the proximal cap. Reentry into the distal true lumen was achieved using the stick and drive technique with a Gaia 3rd wire with an excellent final result after stenting.
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Thanks for the excellent case presentation.
Beautiful case. Thanks. We are very grateful for your teaching
Looks like Gladius crossed in lumen, could you confirmed it with angio/IVUS ? It would save you re entry device
Agree - IVUS is critical here
Why not using sasuke microcatheter
During antegrade
Great point - we did use a dual lumen microcatheter because we had live IVUS guidance of the proximal cap puncture. Using a dual lumen microcatheter would help with support but not sure it would necessarily change the course of the wire, especially after the wire followed the initial suboptimal course.