×
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


Case summary

  • Patient: male 58 y
  • 8 March 2016 cardiac arrest playing soccer with friends
  • VF and ROSC after successful defibrillation, normal ECG
  • 2 vessel disease:  severe stenosis of proximal RCA   CTO of proximal RCX
  • PCI march 2016:  RCA with one DES, try to open RCX, unsuccessful
  • Normal renal function, no anemia, only slight Troponin raise
  • CVRF:  dyslipidemia, hypertension, smoker
  • ICD Implantation April 2016
  • MRI 29.3.16:  LVEF 45-50%
  • Ischemia in the RCX territory
  • JCTO score 3:
  • Blunt proximal cap
  • Long lesion
  • Bending
  • Landing zone : distal cap

Description of procedure

  • Right femoral approach
  • Distal injection to check the right branch
  • Proximal cap dilatation (2.5 balloon)
  • 2.35 stent
 
 
Shooting date : 2016-06-27
Last update : 2017-08-03
Daniel Weilenmann
St. Gallen, Switzerland

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
24 comments
Join the Discussion
See previous comments (19)
  • Kare T. Should you be more careful with antegrade injection due to risk of hydronic dissection?

      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.


    • Olaf R. why did he not change again to fielder XT again after penetrating the proximal cap with a stiffer wire?

      • Ayman T. i think Sion blue was used to deeply engage LCX

      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.


    • Ayman T. very useful

        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.


      • Umar S. Well done great job

          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.


        • Stefan H. Congratulations, nice procedure!

            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.


          • Raisakis K. Nice

              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.


            • Zambonialbe A. Well done!

                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.


              • Aquilina M. Which kind of wire do you use?

                  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.


                • Daniel W. Treating CTOs in the hybrid algorithm we use mostly as a step up approach Fielder XT, then Pilot 200, GLADIUS or GAIA family, then Conquest Pro 12 or Hornet 14. Mostly depending on the anatomic presentation of the CTO.

                    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.


                  • Daniel W. Thank you all for the comments and the support

                      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.


                    • evi supriadi S. good case, well done

                        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 M. Good

                          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.


                        • Sarteep Ezzat Q. 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 M. Good

                              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.


                            • Dirk P. Excellent result !
                              Learning point for me was the dilatation of the proximal cap with low profile balloon to facilitate the micro catheter. many thanks , Dirk P

                                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.


                              • Khalid A. great results .. I would've saved some time using a guide extension to help with the Cx angulation . but nicely done .

                                  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.


                                • Hernan V. Exelent

                                    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.


                                  • hashemi fard O. Excellent

                                      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.


                                    • Usman K. Good case

                                        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.


                                      • maher T. EXCELLENT

                                          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.


                                        • dow R. https://www.google.com/

                                            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.


                                          • dow R. good

                                              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.


                                            • Dorin D. great job!

                                                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.


                                              Suggestions

                                              Wednesday, March 24th 2021 from 06:30pm to 07:30pm (GMT+1)
                                              Honolulu : Wednesday, March 24th 2021 from 07:30am to 08:30am (GMT-10)
                                              San Francisco : Wednesday, March 24th 2021 from 09:30am to 10:30am (GMT-8)
                                              New York : Wednesday, March 24th 2021 from 12:30pm to 01:30pm (GMT-5)
                                              Buenos Aires : Wednesday, March 24th 2021 from 02:30pm to 03:30pm (GMT-3)
                                              London / Dublin : Wednesday, March 24th 2021 from 05:30pm to 06:30pm (GMT)
                                              Paris / Berlin : Wednesday, March 24th 2021 from 06:30pm to 07:30pm (GMT+1)
                                              Istanbul : Wednesday, March 24th 2021 from 07:30pm to 08:30pm (GMT+2)
                                              Moscou / Dubaï : Wednesday, March 24th 2021 from 09:30pm to 10:30pm (GMT+4)
                                              Bangkok : Thursday, March 25th 2021 from 12:30am to 01:30am (GMT+7)
                                              Shanghai : Thursday, March 25th 2021 from 01:30am to 02:30am (GMT+8)
                                              Tokyo : Thursday, March 25th 2021 from 02:30am to 03:30am (GMT+9)
                                              Sydney : Thursday, March 25th 2021 from 03:30am to 04:30am (GMT+10)
                                              Wellington : Thursday, March 25th 2021 from 05:30am to 06:30am (GMT+12)

                                              When CTO meets Bifurcation: Discover expert insights

                                              Episode 2: Distal & Intra-lesion Bifurcations

                                              Share
                                              Monday, November 30th -0001 from 12am to 12am (GMT+1)
                                              Honolulu : Monday, November 29th 1999 from 01pm to 01pm (GMT-10)
                                              San Francisco : Monday, November 29th 1999 from 03pm to 03pm (GMT-8)
                                              New York : Monday, November 29th 1999 from 06pm to 06pm (GMT-5)
                                              Buenos Aires : Monday, November 29th 1999 from 08pm to 08pm (GMT-3)
                                              London / Dublin : Monday, November 29th 1999 from 11pm to 11pm (GMT)
                                              Paris / Berlin : Tuesday, November 30th 1999 from 12am to 12am (GMT+1)
                                              Istanbul : Tuesday, November 30th 1999 from 01am to 01am (GMT+2)
                                              Moscou / Dubaï : Tuesday, November 30th 1999 from 03am to 03am (GMT+4)
                                              Bangkok : Tuesday, November 30th 1999 from 06am to 06am (GMT+7)
                                              Shanghai : Tuesday, November 30th 1999 from 07am to 07am (GMT+8)
                                              Tokyo : Tuesday, November 30th 1999 from 08am to 08am (GMT+9)
                                              Sydney : Tuesday, November 30th 1999 from 09am to 09am (GMT+10)
                                              Wellington : Tuesday, November 30th 1999 from 11am to 11am (GMT+12)

                                              Complex CTO: Ostial LAD CTO with ambiguous Proximal CAP

                                              Case of the month: May 2019

                                              Share
                                              Scroll Up