2. Male, 56 year old, dyslipidemic
2013: onset of moderate effort angina; a stress
myocardial scintigraphy showed a perfusion defect of
the anterior wall. Normal LV function
05/2014: angiografic evidence of ostial LAD CTO.
Patient refused the surgical option.
7. fibrocalcific
Antegrade puncture of the entry point by Conquest Pro 9/12 and Gaia Third failed
because the wires slipped away in the Circ.
Microcatheter: Crusade
26. 1.25 mm balloon
After 5 hours of procedure, 122 min of
fluoroscopy time , 287 ml of contrast and
6 grays of AIR KERMA I gave up the
procedure
The patient had no periprocedural
or in hospital complication.
He didn’t accept any surgical solution
27. Guidewire bidirectional ‘uncrossable’ ostial CTO
Which is the best strategy if the parent vessel is an
unprotected left main?
Is subintimal approach feasible?
In which cases?
28. Antegrade penetration is mandatory if you need a
reverse CART for LAD/CFX ostial occlusion
Because of the complex geometry of the L.M. it’s
crucial to maintain the integrity of the ostia
Reverse CART of the unprotected LM, even if IVUS
guided, can be very dangerous
This condition is for me a true and unique
controindication to the reverse CART
Stent reverse CART is safe but may be unsuccessful
I am eager to know your opinion about…
Thank you very much !!!
