A successful treatment for a lesion of chronic total occlusion using a virtual 3 Fr guiding catheter
Reo Nakamura1, Keisuke Ota, Nobuyuki Miyai
1Division of Cardiovascular Center, Kouseikai Takeda Hospital, 841-5 Higashishiokoji-cho, Shimogyo-ku, Kyoto, Kyoto, Japan. n_rreo@yahoo.co.jp
Insights
This study demonstrates successful treatment of chronic total coronary artery occlusion using slender devices. Careful device selection and lesion assessment are key for effective intervention in complex cases.
Area of Science:
- Interventional Cardiology
- Cardiovascular Medicine
- Medical Devices
Background:
- Chronic total coronary artery occlusion (CTO) presents a significant challenge in interventional cardiology.
- Successful revascularization of CTOs can improve myocardial perfusion and patient outcomes.
- Limited treatment options exist for CTOs, especially when complex anatomy is involved.
Abstract:
A 43 year-old man was admitted due to effort related chest squeezing for 3 months. Coronary angiogram showed a total occlusion of the proximal right coronary artery (RCA) with collateral vessels from left anterior descending artery. The 5F sheathless guiding catheter was engaged into the RCA and the 3F JL3.5 catheter was inserted into left coronary artery via left radial artery for simultaneous contra lateral angiography. We advanced the wire through the lesion with 2 wire technique. Three XIENCE stents (2.5 mm × 28 mm) was inserted from distal to mid RCA, and a 3.0 mm × 15 mm XIENCE stent was inserted to proximal RCA. The final angiographic result showed well expanded stent. The treatment of chronic total occlusion could be possible even slender device by getting hold of the characteristics of the device and evaluating an objective assessment of lesion characteristics.
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