Case 177: Manual of PCI - Tough to wire ostial RCA lesion скачать в хорошем качестве

Case 177: Manual of PCI - Tough to wire ostial RCA lesion

A patient presented with NSTEMI and was found to have an ostial RCA lesion. Engagement of the RCA was challenging despite using multiple guide catheters. Eventually a wire could only be advanced into the conus branch but not in the RCA and the procedure was aborted. The following day a repeat attempt for PCI was performed. A Sion black wire was advanced into the conus branch through an AL 0.75 guide but wiring the RCA failed despite using multiple wires through a single and dual lumen microcatheter. Using the “air mail” technique (wire advancement with the guide not fully engaged in the vessel ostium) a Fielder XTR wire was finally advanced into the RCA through a Corsair XS microcatheter. It was exchanged for a Wiggle wire, followed by successful angioplasty and stenting.