Case 162: Manual of CTO PCI - Recurrent SVG failure скачать в хорошем качестве

Case 162: Manual of CTO PCI - Recurrent SVG failure

A patient was referred for PCI of a native circumflex CTO due to recurrent failure of a saphenous vein graft to the obtuse marginal branch. The lesion was heavily calcified. The CTO was successfully crossed using the retrograde approach and the guide extension reverse CART technique, followed by guidewire externalization. Antegrade crossing of the lesion failed despite using small balloons including a 1.0 mm balloon. Rotational atherectomy was performed with a 1.5 mm burr followed by successful antegrade crossing of the lesion and stenting all the way to the left main ostium. The SVG was subsequently occluded with a 6 mm Amplatzer Vascular Plug 2 that was delivered through a guide extension.