Case 259: Manual of CTO PCI - Ultra low contrast CTO PCI

[@Hanin243]

Nicely done 👍, interestingly how quite often it’s not too challenging to wire chronically occluded graft and use as retrograde route thanks

[@ivankoshkin837]

I guess it is just true to true crossing. Otherwise even for directed Reverse-CART small balloon would have been used to cross retrogradely through that space. Moreover it is too dangerous to rota being subintimal. Interesting what IVUS showed? Great case, thanks! 👏🏻

[@shangz0216]

Thanks for the excellent case presentation.

[@indiechique2059]

I would say that in ckd esrd there’s not much to save in kidneys, just do dialysis post procedure and you’ll be fine. Yes this technique holds true in Aki where we want to save kidneys. Many authors are of view that contrast doesn’t worsen kidney functions, usually it’s due to plaque embolisation

[@Miguel-mb9xt]

Why attempting retrograde, if it was demonstrated that it was a chronic oclussion of the graft?

[@muhammadyolandisumadio1547]

It seems that you dont need the retrograde approach. Since your filder xt a and rota wire and even rota can pass antegradely. Why need to reverse cart then?