Case 71 - Manual of PCI: serial troubleshooting

A patient with heavy coronary calcification on coronary CT angiography underwent coronary angiography showing several ostial and mid/distal right coronary artery lesions, ostial ramus and diffuse LAD disease. Physiologic assessment showed that the LAD and ramus were not significant hence PCI of the RCA was undertaken.
Balloon angioplasty of the ostial lesion was performed to minimize dampening followed by insertion of a 7 French Telescope for facilitating delivery. Advancement of a 4x40 mm DES through the collar of the guide extension was challenging resulting in stent loss. A 1.5 mm balloon was advanced through the lost stent, inflated and withdrawn together with the lost stent (small balloon technique). Additional predilation was done. The distal anchor technique failed to deliver a stent, but deep engagement of the guide extension using the inch-worming technique was successful with an excellent final result.

Видео Case 71 - Manual of PCI: serial troubleshooting канала Manos Brilakis