We decided to treat distal RCA CTO lesion by optimal medical therapy and to perform intervention at left main to middle LAD. An 8 Fr sheath was inserted through right femoral artery, and the left coronary ostium was engaged with an 8 Fr JL 4.0 catheter with side hole. Firstly, we advanced to LCX and LAD with Soft wire 0.014-inch guidewire and predilatation was performed with a 2.5 x 15mm Black Hawk balloon (Figure 1). Subsequently, Xience Xpedition 2.75 x 28 mm and Xience Xpedition 3.25 x 33 mm were implanted at left main to middle LAD (Figure 2, Figure 3) Post-stenting adjunctive balloon dilatation using Empira NC 3.5 x 20 mm (Figure 4). We check angiogram, which showed good maintance of patency at proximal LCX ( Movie 5). So we removed wire at LCX, followed by additional adjunctive balloon dilatation with Quantum 4.5 x 8 mm at left main to proximal LAD (Figure 5). Final angiogram showed that the procedure was successful ( Movie 6, Movie 7). |
Leave a comment