CTO PCI procedure for left anterior descending artery

Operators:Prof. Dr. Şevket Görgülü

Acibadem University of Medicine, Kocaeli Acibadem Hospital


A 60-year-old male patient was decided to be undergone coronary bypass surgery after coronary angiography performed at the external center.


Dual angiography from the right radial and right femoral access revealed a J-CTO score of 0 in the LAD CTO case (Video 1). The 7Fr CLS was introduced into the left system via the femoral access with the guide catheter, the micro channel was detected, and the wire advancement was taken with Corsair and Fielder XT-R (video 2). After an interval of 5 minutes, antegrade wire advancement was performed and we were observed to be luminal in the side branch with retrograde image (video 3). The wire was pulled back and redirected into main vessel (video 4) and tip injection confirmed the true lumen (video 5). Afterwards, CTO wire was exchanged with a workhorse wire and Corsair was removed with a coronary trap balloon (video 5). After predilatation with 2.0×30 balloon (video 7), a 2.5×38 Xience stent was inflated with 16 atm (video 8) . LAD total lesion was accepted as successful PTCA + stent (video 9). The LAD proximal bifurcation lesion will be evaluated after 1 month with FFR.

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