A patient presented with anterior STEMI and was found to have occlusion of the mid LAD right after a diagonal branch. Guide engagement was challenging but was facilitated by use of an “anchor” guidewire into the circumflex. Wiring through the LAD occlusion failed despite using a microcatheter and multiple workhorse and polymer-jacketed wires, including Sion black and Gladius Mongo. Eventually, a Sasuke microcatheter was inserted over the diagonal guidewire and a Gaia Next 2 wire successfully crossed the LAD into the distal true lumen, as confirmed by contralateral injection.
This is an example of how CTO PCI techniques (contralateral injection, use of single and dual lumen microcatheters, and use of polymer-jacketed and stiff tip, torquable guidewires can facilitate non-CTO PCI.
Негізгі бет Тәжірибелік нұсқаулар және стиль Case 174: Manual of PCI - Challenging wiring in STEMI
Пікірлер: 10