×
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.

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


Chapters (7)
Description
Shooting date : 2018-10-30
Last update : 2020-03-09
Language(s) : English
This complete didactic procedure concerns a 68 yo male, with history of LAD PCI. The coronary angiography has also shown proximal RCA ...
This complete didactic procedure concerns a 68 yo male, with history of LAD PCI. The coronary angiography has also shown proximal RCA Chronic Total Occlusion with residual proven ischemia.
 
This Proximal RCA Chronic Total Occlusion was recanalized retrogradely through epicardial collaterals with good final result.

Educational objectives

  • How to manage patients with coronary CTO.
  • How to apply the Hybrid algorithm during coronary CTO procedures.
  • How to perform antegrade Knuckle wire Technique.
  • How to select & approach epicardial collaterals.
  • How to perform Reverse CART Technique.

Step-by-Step Procedure

  • Double Access: Right Femoral 7F, Left Radial 6F.
  • Dual injection & angiographic evaluation.
  • Antegrade approach using Turnpike Spiral (Teleflex) & Fielder XT-A (Asahi) and then Gaia 3rd guidewire (Asahi).
  • Antegrade wire Knuckling to the distal RCA using Fielder XT-A.
  • Distal re-entry failure with Pilot 200 (Abbott).
  • Retrograde Approach using epicardial collaterals from Left Cx: Sion guidewire (Asahi) & Turnpike LP (Teleflex).
  • Revere CART technique using a 3.5x20mm balloon, guideliner V3 support (Teleflex) & Pilot 200 guidewire (Abbott).
  • Predilatation.
  • Stenting with multiple  DES  Supraflex (Teleflex).
  • Left system microcatheter removing & control.
  • Final result.

Protocol

  • Procedural time: 120min.
  • Contrast medium: 310ml (Ultravist)
  • Exposure: 1.6 Gy.
  • Fluoroscopic time: 65min.

Biobliography

Linked playlists (2)
Comments(7)
Join the Discussion
See previous comments (3)
  • 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.


    • omer S. thank you. very good 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.


      • Nihat O. Exclude final viwe good 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.


        • Muhammad Asghar K. Excelent and very educational

            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.


          • Pecheux M. Vert pedagogic

              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.


            • Deogenes M. Amazing video

                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.


              • albayrak S. Z

                  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.


                Wednesday, October 31st 2018 from 12:30pm to 02pm (GMT+2)
                Honolulu : Wednesday, October 31st 2018 from 12:30am to 02am (GMT-10)
                San Francisco : Wednesday, October 31st 2018 from 02:30am to 04am (GMT-8)
                New York : Wednesday, October 31st 2018 from 05:30am to 07am (GMT-5)
                Buenos Aires : Wednesday, October 31st 2018 from 07:30am to 09am (GMT-3)
                London / Dublin : Wednesday, October 31st 2018 from 10:30am to 12pm (GMT)
                Paris / Berlin : Wednesday, October 31st 2018 from 11:30am to 01pm (GMT+1)
                Istanbul : Wednesday, October 31st 2018 from 12:30pm to 02pm (GMT+2)
                Moscou / Dubaï : Wednesday, October 31st 2018 from 02:30pm to 04pm (GMT+4)
                Bangkok : Wednesday, October 31st 2018 from 05:30pm to 07pm (GMT+7)
                Shanghai : Wednesday, October 31st 2018 from 06:30pm to 08pm (GMT+8)
                Tokyo : Wednesday, October 31st 2018 from 07:30pm to 09pm (GMT+9)
                Sydney : Wednesday, October 31st 2018 from 08:30pm to 10pm (GMT+10)
                Wellington : Wednesday, October 31st 2018 from 10:30pm to 12am (GMT+12)

                CHIP : The Italian Way

                Complex and High Risk Indicated Patients

                Share
                Scroll Up