Cardiology
Endovascular
IR
- Embolization
- Others
CRM
- EP
- RF ablation
More
- Channels
- Hall of fame
  - Industry
  - Institutions
  - Experts
  - Events
  - Media

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.

Very challenging retrograde RCA CTO

It is not done, until it’s done!

Cardiology / Coronary / Cto / Case in the box

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

Worldwide schedules comment Share

2 chapters

1 - Beginning of the case Start time : 4min.5s.
2 - Summary Start time : 38min.28s.

DESCRIPTION
Equipment used

Case summary

Patient Demographics

Age: 66 years old

Gender: male

Medical History

NIDDM; Hypertension; Dyslipidaemia

Previous smoking history

Previous femoral PTCA

Known IHD:

1998: Anterior STEMI - Thrombolysis + PCI of proximal LAD (BMS)

2002: CTO of RCA: medical management

2016: ICD (EF 35% + NSVT)

Clinical Presentation

Stable angina (CCS III)

Nuclear perfusion imaging: inducible ischaemia of infero-lateral wall

Coronary angio

Normal LM

LAD:

moderate ISR (FFR 0.79)

severe stenosis mid-LAD

PCI with two overlapping DESs

M1: severe stenosis

RCA: CTO of proximal segment with septal collaterals from LAD

Strategy

ACCESSES
Radial: XB 3.5 6Fr 90 cm
Femoral: AL1 7Fr 100 cm; long sheath

APPROACHES
Retrograde approach through septal collaterals (Turnpike LP and Sion)
Retrogade true-to-true
Retrograde dissection and re-entry
Antegrade dissection reentry
Antegrade approach with guidewire escalation

Protocol: OptiRAY (Ioversol)

Concentration: 350 mgl/mL

Volume: 220 mL

Shooting date : 2017-01-26
Last update : 2021-06-09

Mauro Carlino

Milan, Italy

Private message

Lorenzo Azzalini

Milan, Italy

Private message

Antonio Colombo

Milan, Italy

Private message

OptiRAY® / Guerbet

Optiray® contrast agent is lower osmolar, lower viscosity and nonionic.

Hi-Torque PILOT 200 Guide wire / Abbott

Antegrade escalation & Knuckle

ASAI Gaia Second / Asahi

RG3Ⓡ Guide wire / Asahi

Retrograde approach

CORSAIR Microcatheter / Asahi

Guideliner / Vascular Solutions

Be the first to comment

Suggestions

01:12:49

Watch

Tuesday, April 23^rd 2024 from 05pm to 06:15pm (GMT+2)

Honolulu : Tuesday, April 23^rd 2024 from 05am to 06:15am (GMT+2)
San Francisco : Tuesday, April 23^rd 2024 from 08am to 09:15am (GMT+2)
New York : Tuesday, April 23^rd 2024 from 11am to 12:15pm (GMT+2)
Buenos Aires : Tuesday, April 23^rd 2024 from 12pm to 01:15pm (GMT+2)
Reykjavik : Tuesday, April 23^rd 2024 from 03pm to 04:15pm (GMT+2)
London / Dublin : Tuesday, April 23^rd 2024 from 04pm to 05:15pm (GMT+2)
Paris / Berlin : Tuesday, April 23^rd 2024 from 05pm to 06:15pm (GMT+2)
Istanbul : Tuesday, April 23^rd 2024 from 06pm to 07:15pm (GMT+2)
Moscou / Dubaï : Tuesday, April 23^rd 2024 from 07pm to 08:15pm (GMT+2)
Bangkok : Tuesday, April 23^rd 2024 from 10pm to 11:15pm (GMT+2)
Shanghai : Tuesday, April 23^rd 2024 from 11pm to 12:15am (GMT+2)
Tokyo : Wednesday, April 24^th 2024 from 12am to 01:15am (GMT+2)
Sydney : Wednesday, April 24^th 2024 from 02am to 03:15am (GMT+2)
Wellington : Wednesday, April 24^th 2024 from 04am to 05:15am (GMT+2)

From Access to Closure through Treatment:

How to Maximize Outcomes while Minimizing Impact

Cardiology / Coronary / Roundtable

Watch

Discover now !

Everything you wanted to know about Recross without having to ask

Alex & The Young Generation - Ep.12

Cardiology / Coronary / Case in the box

50:04

Watch

Wednesday, September 18^th 2024 from 12pm to 01pm (GMT+2)

Honolulu : Wednesday, September 18^th 2024 from 12am to 01am (GMT+2)
San Francisco : Wednesday, September 18^th 2024 from 03am to 04am (GMT+2)
New York : Wednesday, September 18^th 2024 from 06am to 07am (GMT+2)
Buenos Aires : Wednesday, September 18^th 2024 from 07am to 08am (GMT+2)
Reykjavik : Wednesday, September 18^th 2024 from 10am to 11am (GMT+2)
London / Dublin : Wednesday, September 18^th 2024 from 11am to 12pm (GMT+2)
Paris / Berlin : Wednesday, September 18^th 2024 from 12pm to 01pm (GMT+2)
Istanbul : Wednesday, September 18^th 2024 from 01pm to 02pm (GMT+2)
Moscou / Dubaï : Wednesday, September 18^th 2024 from 02pm to 03pm (GMT+2)
Bangkok : Wednesday, September 18^th 2024 from 05pm to 06pm (GMT+2)
Shanghai : Wednesday, September 18^th 2024 from 06pm to 07pm (GMT+2)
Tokyo : Wednesday, September 18^th 2024 from 07pm to 08pm (GMT+2)
Sydney : Wednesday, September 18^th 2024 from 09pm to 10pm (GMT+2)
Wellington : Wednesday, September 18^th 2024 from 11pm to 12am (GMT+2)

Can PCI outcomes get any better?

Advancing the standard of care with bioadaptor

Cardiology / Coronary / Webinar/1 Comments

Watch

Saturday, March 29^th 2025 from 08am to 10pm (GMT+1)

Honolulu : Friday, March 28^th 2025 from 08pm to 10am (GMT+1)
San Francisco : Friday, March 28^th 2025 from 10pm to 12pm (GMT+1)
New York : Saturday, March 29^th 2025 from 01am to 03pm (GMT+1)
Buenos Aires : Saturday, March 29^th 2025 from 03am to 05pm (GMT+1)
London / Dublin : Saturday, March 29^th 2025 from 06am to 08pm (GMT+1)
Paris / Berlin : Saturday, March 29^th 2025 from 07am to 09pm (GMT+1)
Istanbul : Saturday, March 29^th 2025 from 08am to 10pm (GMT+1)
Moscou / Dubaï : Saturday, March 29^th 2025 from 10am to 12am (GMT+1)
Bangkok : Saturday, March 29^th 2025 from 01pm to 03am (GMT+1)
Shanghai : Saturday, March 29^th 2025 from 02pm to 04am (GMT+1)
Tokyo : Saturday, March 29^th 2025 from 03pm to 05am (GMT+1)
Sydney : Saturday, March 29^th 2025 from 04pm to 06am (GMT+1)
Wellington : Saturday, March 29^th 2025 from 06pm to 08am (GMT+1)

Complex & High-Risk Indicated Procedures

Discover the 6^th edition - Day #2

Cardiology / Coronary / Event

01:04:32

Watch

Wednesday, November 23^rd 2022 from 05pm to 06pm (GMT+1)

Honolulu : Wednesday, November 23^rd 2022 from 05am to 06am (GMT+1)
San Francisco : Wednesday, November 23^rd 2022 from 07am to 08am (GMT+1)
New York : Wednesday, November 23^rd 2022 from 10am to 11am (GMT+1)
Buenos Aires : Wednesday, November 23^rd 2022 from 12pm to 01pm (GMT+1)
London / Dublin : Wednesday, November 23^rd 2022 from 03pm to 04pm (GMT+1)
Paris / Berlin : Wednesday, November 23^rd 2022 from 04pm to 05pm (GMT+1)
Istanbul : Wednesday, November 23^rd 2022 from 05pm to 06pm (GMT+1)
Moscou / Dubaï : Wednesday, November 23^rd 2022 from 07pm to 08pm (GMT+1)
Bangkok : Wednesday, November 23^rd 2022 from 10pm to 11pm (GMT+1)
Shanghai : Wednesday, November 23^rd 2022 from 11pm to 12am (GMT+1)
Tokyo : Thursday, November 24^th 2022 from 12am to 01am (GMT+1)
Sydney : Thursday, November 24^th 2022 from 01am to 02am (GMT+1)
Wellington : Thursday, November 24^th 2022 from 03am to 04am (GMT+1)

UNCAGE coronaries - Episode 3 : UNCAGE chronic total occlusions

Cardiology / Coronary / Webinar

02:35:27

Watch

Thursday, March 16^th 2023 from 05pm to 07:30pm (GMT+1)

Honolulu : Thursday, March 16^th 2023 from 05am to 07:30am (GMT+1)
San Francisco : Thursday, March 16^th 2023 from 07am to 09:30am (GMT+1)
New York : Thursday, March 16^th 2023 from 10am to 12:30pm (GMT+1)
Buenos Aires : Thursday, March 16^th 2023 from 12pm to 02:30pm (GMT+1)
London / Dublin : Thursday, March 16^th 2023 from 03pm to 05:30pm (GMT+1)
Paris / Berlin : Thursday, March 16^th 2023 from 04pm to 06:30pm (GMT+1)
Istanbul : Thursday, March 16^th 2023 from 05pm to 07:30pm (GMT+1)
Moscou / Dubaï : Thursday, March 16^th 2023 from 07pm to 09:30pm (GMT+1)
Bangkok : Thursday, March 16^th 2023 from 10pm to 12:30am (GMT+1)
Shanghai : Thursday, March 16^th 2023 from 11pm to 01:30am (GMT+1)
Tokyo : Friday, March 17^th 2023 from 12am to 02:30am (GMT+1)
Sydney : Friday, March 17^th 2023 from 01am to 03:30am (GMT+1)
Wellington : Friday, March 17^th 2023 from 03am to 05:30am (GMT+1)