×
It looks like you're using an obsolete version of internet explorer. Internet explorer is no longer supported by Microsoft since the end of 2015. We invite you to use a newer browser such as Firefox, Google Chrome or Microsoft Edge.
My Player placeholder

Become an Incathlab member and receive full access to its content!

You must be an Incathlab member to access videos without any restrictions. Register for free in one minute and access all services provided by Incathlab.You will also be able to log into Incathlab from your Facebook or twitter account by clicking on login on the top-right corner of Incathlab website.

Registration Login


Patient history

  • Male, 80 years-old
  • High blood pressure
  • Stable angina, normal EKG and echocardiography
  • Large inferior ischemia on cardiac MRI (4-5 segments/17)

Description of lesion  

  • Mid LAD Occlusion
  • Calcification - JCTO score 1
  • Good Collaterality  from RCA
  • Ambiguous origin with branchs
  • Two vessel disease, Circ already treated (stent deployment needed very high pressure)

Description of procedure

  1. LAD recanalisation without post-dilatation stenting
  2. Re-occlusion followed by Second recanalisation and DES stenting 
  • Antegrade approach, with AL2 6 french, Finecross and fielder XT
  • Bilateral injection (1 femoral, 1 radial)
  • Laser as first intention because of difficulty to open the circumflex artery

Devices used

  • ELCA laser ablation catheter (Spectranetics)
  • CVX-300

Learning Points:

  • Role of simple balloon angioplasty
  • How to access and treat a proximal and mid LAD occlusion
Shooting date : 2014-07-01
Last update : 2021-06-09
Peter O'Kane, Md
Bournemouth, United Kingdom

Incathlab CTO course

Your CTO Tutors will suggest you a table of video contents following an educational program from beginner to advanced level, completed by a didactic part with relevant lectures. For a tailored tr...

Share
3 comments
Join the Discussion
  • jehangeer H. RISK OF PERFORATION?

      Please, select your files, click upload button, write your comment and click the send button. (allowed formats : images jpeg, gif, png, and PDF)
      Your browser doesn't have Flash, Silverlight or HTML5 support.


    • Vinod N. Thanks

        Please, select your files, click upload button, write your comment and click the send button. (allowed formats : images jpeg, gif, png, and PDF)
        Your browser doesn't have Flash, Silverlight or HTML5 support.


      • Mohamed amine R. RCA , not LAD

          Please, select your files, click upload button, write your comment and click the send button. (allowed formats : images jpeg, gif, png, and PDF)
          Your browser doesn't have Flash, Silverlight or HTML5 support.


        Scroll Up