Case 116: Manual of CTO Interventions: Cutting-balloon assisted reverse CART
Автор: Manos Brilakis
Загружено: 2018-10-27
Просмотров: 4660
Описание: A patient was referred for PCI of a right coronary artery chronic total occlusion. Antegrade wire escalation failed, as the proximal cap could not be penetrated despite using various guidewires. A retrograde guidewire and microcatheter were advanced via a septal collateral next to the antegrade guidewire in the proximal RCA, but reverse CART failed. IVUS showed that the retrograde guidewire was in the subintimal space whereas the antegrade guidewire was in the true lumen. After using a cutting balloon over the antegrade guidewire a R350 retrograde guidewire crossed into the aorta. The R350 was successfully snared and externalized, followed by stenting and an excellent final result. In summary, when the retrograde guidewire is subintimal and the antegrade guidewire within the proximal true lumen, use of a cutting balloon can facilitate retrograde guidewire crossing.
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