Video : Complex CTO right coronary recanalization. Ambiguous proximal cap

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Cardiology / Coronary / Cto / Case in the box

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Patient history

56 years old male
Risk factors : dyslipidemia
Medical history : anginal pain and dyspnea on exertion
Preliminary tests : normal exercise-stress test (sub-maximal)
Myocardial scintigraphy : 15% infero-lateral ischemia
Coronary angiogram : stenosis of the mid Cx artery and CTO of the RCA. Angioplasty of the Cx artery
Treatment : aspegic, clopidogrel, rosuvastatin
Echocardiography : LVEF 53%
ECG : normal
Biology : serum creatinine = 8.3 mg/dl
Premedication : sedation (midazolam), heparin 5000 UI

Planned procedure

Right femoral access for coronary angioplasty and right radial access for contralateral injection
Placement of an AL 2 catheter(Cordis) in the RCA
Antegrade wiring approach with intermediate stiff guidewire. Escalation of guidewires
Retrograde approach in case of failure

Procedure datas

Exposure : 1,1 Gy
Contrast : 180 ml
Duration : 45 min

Shooting date : 2014-02-05
Last update : 2021-06-09