Рет қаралды 1,857
A patient was referred for PCI of an RCA CTO due to medically refractory angina. The RCA was heavily calcified with an ambiguous proximal cap at the origin or a large acute marginal, short occlusion length, good quality distal vessel and septal/epicardial collaterals. Antegrade wiring entered into the acute marginal. Parallel wiring with a Sasuke failed, but a Gladius Mongo eventually entered into the extraplaque space distal to the occlusion. Delivery of a Stingray was challenging, but was eventually successful using a 7 French Trapliner, predilatation with a 1.0 mm Sapphire balloon, use of a Miracle 3 wire and use of a new Stingray balloon. The distal true lumen was successfully entered using the "stick and drive" technique with a Gaia 3rd wire, followed by stenting that was optimized with IVUS and use of an Ostial Flash balloon. A nice final result was achieved.