×
It looks like you're using an obsolete version of internet explorer. Internet explorer is no longer supported by Microsoft since the end of 2015. We invite you to use a newer browser such as Firefox, Google Chrome or Microsoft Edge.
My Player placeholder

Become an Incathlab member and receive full access to its content!

You must be an Incathlab member to access videos without any restrictions. Register for free in one minute and access all services provided by Incathlab.You will also be able to log into Incathlab from your Facebook or twitter account by clicking on login on the top-right corner of Incathlab website.

Registration Login


Patient's Presentation

  • Gender: NC
  • Age: 66 years old

Prior clinical history

  • PCI Left Main/LAD 08/23
  • Risk factors: HTA, Dyslepidemia, Diabetis, ex smoker

Clinical Presentation

  • Scintigraphia: inferior & lateral ischemia
  • Echocardiography: EF 55%

Angiography


 

Shooting date : 2023-11-29
Last update : 2025-06-26
Alexandre Avran
Valenciennes, France
Stéphane Rinfret
Atlanta, United States

Alex & Friends

Discover a NEW CTO Live Cases series This series will bring together members of the CTO community to chat and share their experiences. Every month Alexandre Avran will invite a close frien...

Share
9 comments
Join the Discussion
See previous comments (2)
  • george M. Very informative from one of the best!

    Please, select your files, click upload button, write your comment and click the send button. (allowed formats : images jpeg, gif, png, and PDF)
    Your browser doesn't have Flash, Silverlight or HTML5 support.


  • Aymen B. Wow many struggles and complications nicely managed from 2 masters !

    Please, select your files, click upload button, write your comment and click the send button. (allowed formats : images jpeg, gif, png, and PDF)
    Your browser doesn't have Flash, Silverlight or HTML5 support.


  • Marin V. Vauuu... Full house of very nice managed extreme coronary intervention complication! Very useful tips, thank you. Was there any room or need for perinterventional cardiac echo?

    • Alexandre A. Yes we did Echo after the case, no effusion,
      Thanks for following us

    Please, select your files, click upload button, write your comment and click the send button. (allowed formats : images jpeg, gif, png, and PDF)
    Your browser doesn't have Flash, Silverlight or HTML5 support.


  • Ahmed E. Awesome work by two master operators. A live demo of the various challenges faced during CTO PCI beyond wire crossing. Loved the rota tips. Had the same experience with OPN balloons in a similar scenario where a spike of calcium kept rupturing every other balloon ????????????????

      Please, select your files, click upload button, write your comment and click the send button. (allowed formats : images jpeg, gif, png, and PDF)
      Your browser doesn't have Flash, Silverlight or HTML5 support.


    • ahmed B. A very tough case & elegant performance. Also very unusual mishap regarding the wasted ballons, and the damaged Burr.
      Finally the CX lookks amazing at the end
      Very happy to see both of you scrubbed on a case
      It really has to be undoubtly tough since you both there.
      Yours
      A fond fan of you

        Please, select your files, click upload button, write your comment and click the send button. (allowed formats : images jpeg, gif, png, and PDF)
        Your browser doesn't have Flash, Silverlight or HTML5 support.


      • Mohamed R. Very informative case with lots of well managed complications, some questions if I may, retrospectively was using IVL before rota or even after stenting of LCx ostium a good option, then how is LAD flow restored despite using a covered stent from LM to LCx ?

          Please, select your files, click upload button, write your comment and click the send button. (allowed formats : images jpeg, gif, png, and PDF)
          Your browser doesn't have Flash, Silverlight or HTML5 support.


        Suggestions

        Tuesday, March 29th 2022 from 06pm to 07pm (GMT+2)
        Honolulu : Tuesday, March 29th 2022 from 06am to 07am (GMT+2)
        San Francisco : Tuesday, March 29th 2022 from 09am to 10am (GMT+2)
        New York : Tuesday, March 29th 2022 from 12pm to 01pm (GMT+2)
        Buenos Aires : Tuesday, March 29th 2022 from 01pm to 02pm (GMT+2)
        Reykjavik : Tuesday, March 29th 2022 from 04pm to 05pm (GMT+2)
        London / Dublin : Tuesday, March 29th 2022 from 05pm to 06pm (GMT+2)
        Paris / Berlin : Tuesday, March 29th 2022 from 06pm to 07pm (GMT+2)
        Istanbul : Tuesday, March 29th 2022 from 07pm to 08pm (GMT+2)
        Moscou / Dubaï : Tuesday, March 29th 2022 from 08pm to 09pm (GMT+2)
        Bangkok : Tuesday, March 29th 2022 from 11pm to 12am (GMT+2)
        Shanghai : Wednesday, March 30th 2022 from 12am to 01am (GMT+2)
        Tokyo : Wednesday, March 30th 2022 from 01am to 02am (GMT+2)
        Sydney : Wednesday, March 30th 2022 from 03am to 04am (GMT+2)
        Wellington : Wednesday, March 30th 2022 from 05am to 06am (GMT+2)

        The Role of Mechanical Circulatory Support in Complex VT Cases

        Share
        Thursday, May 30th 2024 from 07:30am to 10:30pm (GMT+2)
        Honolulu : Wednesday, May 29th 2024 from 07:30pm to 10:30am (GMT+2)
        San Francisco : Wednesday, May 29th 2024 from 10:30pm to 01:30pm (GMT+2)
        New York : Thursday, May 30th 2024 from 01:30am to 04:30pm (GMT+2)
        Buenos Aires : Thursday, May 30th 2024 from 02:30am to 05:30pm (GMT+2)
        Reykjavik : Thursday, May 30th 2024 from 05:30am to 08:30pm (GMT+2)
        London / Dublin : Thursday, May 30th 2024 from 06:30am to 09:30pm (GMT+2)
        Paris / Berlin : Thursday, May 30th 2024 from 07:30am to 10:30pm (GMT+2)
        Istanbul : Thursday, May 30th 2024 from 08:30am to 11:30pm (GMT+2)
        Moscou / Dubaï : Thursday, May 30th 2024 from 09:30am to 12:30am (GMT+2)
        Bangkok : Thursday, May 30th 2024 from 12:30pm to 03:30am (GMT+2)
        Shanghai : Thursday, May 30th 2024 from 01:30pm to 04:30am (GMT+2)
        Tokyo : Thursday, May 30th 2024 from 02:30pm to 05:30am (GMT+2)
        Sydney : Thursday, May 30th 2024 from 04:30pm to 07:30am (GMT+2)
        Wellington : Thursday, May 30th 2024 from 06:30pm to 09:30am (GMT+2)

        CTO LIVE AID 2024

        5th edition

        Share
        Wednesday, October 4th 2023 from 06pm to 06:45pm (GMT+2)
        Honolulu : Wednesday, October 4th 2023 from 06am to 06:45am (GMT+2)
        San Francisco : Wednesday, October 4th 2023 from 09am to 09:45am (GMT+2)
        New York : Wednesday, October 4th 2023 from 12pm to 12:45pm (GMT+2)
        Buenos Aires : Wednesday, October 4th 2023 from 01pm to 01:45pm (GMT+2)
        Reykjavik : Wednesday, October 4th 2023 from 04pm to 04:45pm (GMT+2)
        London / Dublin : Wednesday, October 4th 2023 from 05pm to 05:45pm (GMT+2)
        Paris / Berlin : Wednesday, October 4th 2023 from 06pm to 06:45pm (GMT+2)
        Istanbul : Wednesday, October 4th 2023 from 07pm to 07:45pm (GMT+2)
        Moscou / Dubaï : Wednesday, October 4th 2023 from 08pm to 08:45pm (GMT+2)
        Bangkok : Wednesday, October 4th 2023 from 11pm to 11:45pm (GMT+2)
        Shanghai : Thursday, October 5th 2023 from 12am to 12:45am (GMT+2)
        Tokyo : Thursday, October 5th 2023 from 01am to 01:45am (GMT+2)
        Sydney : Thursday, October 5th 2023 from 03am to 03:45am (GMT+2)
        Wellington : Thursday, October 5th 2023 from 05am to 05:45am (GMT+2)

        Guides de 1ère intention :

        algorithme décisionnel de la lésion simple à la lésion complexe

        Share
        Tuesday, October 4th 2022 from 05pm to 06:15pm (GMT+2)
        Honolulu : Tuesday, October 4th 2022 from 05am to 06:15am (GMT+2)
        San Francisco : Tuesday, October 4th 2022 from 08am to 09:15am (GMT+2)
        New York : Tuesday, October 4th 2022 from 11am to 12:15pm (GMT+2)
        Buenos Aires : Tuesday, October 4th 2022 from 12pm to 01:15pm (GMT+2)
        Reykjavik : Tuesday, October 4th 2022 from 03pm to 04:15pm (GMT+2)
        London / Dublin : Tuesday, October 4th 2022 from 04pm to 05:15pm (GMT+2)
        Paris / Berlin : Tuesday, October 4th 2022 from 05pm to 06:15pm (GMT+2)
        Istanbul : Tuesday, October 4th 2022 from 06pm to 07:15pm (GMT+2)
        Moscou / Dubaï : Tuesday, October 4th 2022 from 07pm to 08:15pm (GMT+2)
        Bangkok : Tuesday, October 4th 2022 from 10pm to 11:15pm (GMT+2)
        Shanghai : Tuesday, October 4th 2022 from 11pm to 12:15am (GMT+2)
        Tokyo : Wednesday, October 5th 2022 from 12am to 01:15am (GMT+2)
        Sydney : Wednesday, October 5th 2022 from 02am to 03:15am (GMT+2)
        Wellington : Wednesday, October 5th 2022 from 04am to 05:15am (GMT+2)

        Quand le patient et l’angiographie racontent des histoires différentes

        Pourquoi le diagnostic des anomalies ou dysfonctions microcirculatoires est important

        Share
        Monday, October 30th 2023 from 05pm to 06pm (GMT+1)
        Honolulu : Monday, October 30th 2023 from 05am to 06am (GMT+1)
        San Francisco : Monday, October 30th 2023 from 07am to 08am (GMT+1)
        New York : Monday, October 30th 2023 from 10am to 11am (GMT+1)
        Buenos Aires : Monday, October 30th 2023 from 12pm to 01pm (GMT+1)
        London / Dublin : Monday, October 30th 2023 from 03pm to 04pm (GMT+1)
        Paris / Berlin : Monday, October 30th 2023 from 04pm to 05pm (GMT+1)
        Istanbul : Monday, October 30th 2023 from 05pm to 06pm (GMT+1)
        Moscou / Dubaï : Monday, October 30th 2023 from 07pm to 08pm (GMT+1)
        Bangkok : Monday, October 30th 2023 from 10pm to 11pm (GMT+1)
        Shanghai : Monday, October 30th 2023 from 11pm to 12am (GMT+1)
        Tokyo : Tuesday, October 31st 2023 from 12am to 01am (GMT+1)
        Sydney : Tuesday, October 31st 2023 from 01am to 02am (GMT+1)
        Wellington : Tuesday, October 31st 2023 from 03am to 04am (GMT+1)

        How do the new antithrombotic recommendations affect your HBR patients?

        Gain insights from a patient case analysis

        Share
        Scroll Up