Скачать с ютуб Case 192: Manual of CTO PCI - Retrograde via SVG в хорошем качестве

Case 192: Manual of CTO PCI - Retrograde via SVG

A patient who had prior CABG twice presented with NSTEMI and was found to have a severe lesion in the distal anastomosis of a SVG-diagonal, as well as significant disease in the mid LAD and occluded RCA as well as other bypass grafts. He was referred for PCI of the LAD CTO that had ambiguous proximal cap. A primary retrograde approach was used via the SVG-diagonal. Support was poor but improved using a Trapliner guide extension. Retrograde wire escalation was successful in crossing the CTO with a Gaia Next 2 wire followed by externalization of an R350 wire and insertion of a workhorse wire into the distal LAD using a Sasuke microcatheter. The LAD lesions was balloon undilatable requiring intravascular lithotripsy, but eventually an excellent result was achieved after stenting. The patient had complete angina resolution.