Case 230: Manual of CTO PCI - Overcoming challenges

[@Sradhananda15]

Fantastic 8 minutes presentation for a 400 minutes procedure... Patience.. persistence commendable.🙏👌

[@shangz0216]

Thanks for the excellent case sharing.

[@hifa63]

Thanks Professor

[@jwilson3985]

6+hr procedure?! Wow. Was the patient under GA or how did they lie flat that long? What was the sedation plan and did it change throughout?

[@fattybum316]

Nice case. How do you decide between switching retro microcatheters or doing rendezvous if you cannot advance the retro MC through the CTO?

[@manosbrilakis]

Rendez vous is very hard to do - it only works if both antegrade and retrograde wire is in the same space (intraplaque or extraplaque) - in most cases when we cannot deliver the microcatheter through the collateral we insert a guide extension and change the microcatheter.

[@fattybum316]

Sorry I meant tip in, in the antegrade guide