The "Proxis-Tornus" technique for a difficult-to-cross calcified saphenous vein graft lesion

Area of Science:

• Interventional Cardiology
• Vascular Surgery

Background:

• Percutaneous coronary intervention (PCI) is a common treatment for coronary artery disease.
• Severely calcified lesions, particularly in saphenous vein grafts (SVGs), pose significant technical challenges during PCI.
• Failure to cross calcified lesions can lead to suboptimal outcomes and procedural complications.

Observation:

• A case of emergency PCI was performed for a calcified SVG lesion.
• Standard crossing techniques, including a 7 Fr guiding catheter, buddy wire, and Tornus catheter, were unsuccessful.
• The difficulty in crossing was attributed to inadequate guide catheter support.

Findings:

• Successful lesion crossing was achieved by employing a novel technique.
• The technique involved the simultaneous use of the Proxis proximal occlusion embolic protection device and the Tornus catheter.
• This combined approach provided sufficient support to navigate the severely calcified lesion.

Implications:

• This case highlights a potential solution for challenging calcified SVG lesions during PCI.
• The combined use of Proxis and Tornus may improve procedural success rates in complex cases.
• Further studies are warranted to evaluate the efficacy and safety of this technique in a larger patient cohort.