Slides
Looks easy, but failed antegrade approach, finally retrograde approach was successful
- Operator : Etsuo Tsuchikane
Looks easy, but failed antegrade approach, finally retrograde approach was successful |
- Operator: Etsuo Tsuchikane, MD |
Case Presentation |
A 63 year-old man was admitted our hospital for effort-related chest pain. We planned PCI before 1Mo, but discovered apical mural thrombi by echocardiogram. So, we started coumadization and delayed PCI. |
Baseline coronary angiography |
The target lesion was a CTO lesion in the proximal LAD. The distal LAD was well filled through the rich collateral channels of right coronary artery via the septal perforators.( Movie 1) Also, some visible contrast filling, suspected as true channel, was also visible in angiogram. |
Procedure |
First, we tried to antegrade approach with IVUS-gruided using by an 8 Fr XB 3.5 guiding catheter and the combination of an Fielder XT 0.014 inch guide-wire and a Finecross¢ç 0.014 inch 1.8 Fr -130cm microcatheter. (Figure 1, Figure 2) But, after wire-crooss to the true lumen, so we used parallel wire technique but also, we failed. |
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