Slides
Anterograde Approach for LCA CTO Lesion
- Operator : Kenya Nasu
Anterograde Approach for LCA CTO Lesion |
- Operator: Kenya Nasu, MD |
Case Presentation |
A 61-year-old male patient was admitted for abnormal electrocardiogram and echocardiogram. He had no effort chest pain and dyspnea on exertion. His coronary risk factor was current-smoking, hypertension and diabetes mellitus. His echocardiogram showed mild LV dysfunction (EF 50%) and RCA/LAD territory regional wall motion abnormality (basal inferior, mid posterior, mid anterior and apical wall). Thallium SPECT showed reversible large decreased perfusion in LAD territory. |
Baseline Coronary Angiogram |
Procedure |
Right coronary artery was engaged with a 7 Fr AR 2 guiding catheter and left coronary artery was positioned with an 7 Fr EBU 3.5 guiding catheter through the bi-femoral approach. After anchoring balloon (Euphora 2.0 x 20 mm) at diagonal artery, we tried to pass the CTO lesion by anterograde approach using Gaia next 1 wire with Caravel 135cm microcatheter ( Appendix RCA view showing retrograde filling of LAD: |
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