Case 269: Manual of CTO PCI - Guide-induced dissection скачать в хорошем качестве

Case 269: Manual of CTO PCI - Guide-induced dissection

A patient presented with exertional dyspnea and was referred for PCI of a high-grade lesion of the mid right coronary artery that appeared to have some antegrade flow through. Antegrade wiring failed. Contrast injection through the antegrade guide catheter resulted in coronary dissection. Re-entry into the distal true lumen using a Stingray balloon failed. Retrograde crossing through the first septal collateral also failed. Retrograde crossing through the 2nd septal collateral was successful, followed by crossing of a retrograde Gladius Mongo wire into the aorta. The retrograde microcatheter was advanced to the ascending aorta and the Gladius Mongo wire was successfully snared within the brachiocephalic artery using an EnSnare through a JR4 guide catheter. The RCA was stented from the distal segment to the ostium with an excellent final result.