Slides
Anterograde and Retrograde Approach for LAD CTO Lesion
- Operator : Seung-Whan Lee
Anterograde and Retrograde Approach for LAD CTO Lesion |
- Operator: Seung-Whan Lee, MD |
Case Presentation |
A 62 year-old male patient was admitted for chest discomfort for several months. His coronary risk factor was smoking and hyperlipidemia. He had previous history of NSTEMI and underwent percutaneous coronary intervention (PCI) at RCA and LCX from other hospital 3 months ago. There was chronic total occlusion (CTO) lesion also at proximal LAD but PCI was failed at that time. He had continued on medical treatment. Echocardiography showed multiple regional wall motion abnormalities with left ventricular systolic function. We decided to revascularize his LAD. |
Baseline Coronary Angiography |
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Procedure |
Right coronary artery was engaged with a 7 Fr AL 1 guiding catheter and left coronary artery was positioned with a 7 Fr XB 3.5 guiding catheter through the bi-femoral approach. We tried to pass the CTO lesion by anterograde approach using Fielder XT, Gaia2 wires with Corsair¢ç 135cm microcatheter. After several trials, anterograde approach was not successful ( Appendix IVUS image of post-ballooning ( |
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