LAD total occlusion – coronary angiogram скачать в хорошем качестве

LAD total occlusion – coronary angiogram

Left coronary angiogram showing a tapering proximal total occlusion of left anterior descending coronary artery. Left circumflex has non flow limiting plaques in the proximal region. Distally it continues as a major obtuse marginal branch, which is free from significant disease. Reflux of contrast into the left sinus of Valsalva is seen, indicating that there is no wedging in the left main coronary artery of the catheter. If the catheter is wedged in the LMCA, there will be damping of catheter tip pressure on the monitor and reflux of contrast will be absent. If this is noted, further contrast injection should be avoided and the catheter withdrawn till a good pressure tracing is obtained. Injection in a wedge position in the left main coronary artery can lead to ostial dissection and destabilization of the patient. This is a transradial angiogram using a Tiger catheter. A total occlusion which has been there for at least one month is usually considered a chronic total occlusion. Opening up a CTO is often difficult and requires special guidewires, better operator experience and patience. Complication rates like dissection and perforation are more common with CTO interventions. Several special type of hardware are sometimes needed to cross CTO.