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Patient history
- Male, 70 years old
- Dyslipidemia, smoking, High blood pressure
- Previous Pace maker in 2006 and CRT-D in 2011
- Admitted for acute pulmonary oedema. EKG normal
- Echo: anterior hypokinesia with EF 30%.
- MRI: anterior viability 100%
- Previous attempt to reopen LAD failed
Description of lesion
- Long occlusion of mid LAD
- Length > 20mm
- Calcification
- Entry point: blunt stump
- Retry
- JCTO score 4
Description of procedure
- Bilateral approach, left and right radial
- Antegrade failure with fine cross and wire escalation (Fielde XT, Ultimate and Gaia 2
- Retrograde approach with corsair
- Retrograde crossing with Gaia 2 and Corsair
- Need for septal pre-dilatation
- Need for creating a shorter guide
- Need for mother and child technique
- Position loose
- Antegrade crossing with Gaia 2 using the retrograde channel created with Corsair
- Undilatable lesion and need for laser
Learning points
- Contrast media 480 cc
- Xray exposure 7.9 Gray
- How to shorten a guiding catheter
- Laser for undilatable lesions
- Antegrade crossing with Gaia 2, through the retrograde channel created by Corsair
Shooting date : 2014-07-01
Last update : 2021-06-09
Last update : 2021-06-09
Incathlab CTO course
Your CTO Tutors will suggest you a table of video contents following an educational program from beginner to advanced level, completed by a didactic part with relevant lectures. For a tailored tr...
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