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Chapters (9)
Shooting date : 2015-09-14
Last update : 2018-05-04

This 40 minutes didactic recorded procedure concerns a symptomatic coronary artery disease patient with a very old long complex mid-RCA occlusion (J-CTO score 4) first attempted retrogradely and then antegradely, using modern strategy and latter tools for coronary artery recanalization.

Step-by-Step Procedure:

  • Description of RCA occlusion and collaterals
  • Main steps of retrograde approach through a diseased LAD. Septal surfing
  • Guidewire escalation for retrograde re-entry
  • Antegrade connection and reverse CART technique
  • Placement of Guiding extension and Rendez-vous technique
  • Externalization of guidewire
  • Predilatation with long balloon
  • Occlusion and distal RCA & mid LAD Stenting
  • Main steps summary of this complex procedure 

Learning points:

  • Management of double arterial access: radial & femoral
  • Antegrade approach
  • Retrograde approach
  • Septal Artery surfing
  • Guidewire escalation
  • Trapping balloon technique
  • Reverse CART technique
  • Rendez-vous technique
  • Guidewire externalization 


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