Скачать с ютуб Case 233: Microcatheter uncrossable CTO в хорошем качестве

Case 233: Microcatheter uncrossable CTO

A prior CABG patient was referred for PCI of an LAD CTO due to medically refractory angina. He had an occluded SVG-LAD and anterior ischemia on nuclear stress test. Antegrade wiring resulted in crossing into a diagonal branch at the proximal cap. Side-BASE failed. We successfully crossed the occluded SVG-LAD with a Mongo wire. We were unable to advance a guidewire retrograde with a SuperCross 120 but were able to advance a Pilot 200 retrogradely via a ReCross dual lumen microcatheter. Guide extension reverse CART was successfully performed but the retrograde Corsair could not cross the CTO. We tried multiple small balloons and microcatheters without success. Antegrade external plaque crush failed as did repeat attempts for retrograde crossing. The proximal segment of the SVG-LAD was stented with plans with repeat PCI attempt of the LAD CTO.