Anterograde LAD CTO - LIVE case

A 66-year-old male presented an ACS two months ago with MVD, preserved LV function without regional wall abnormality. The medical team decided to address this condition with a double PCI: one in the mid-RCA and another in the distal CX. Their plan includes performing PCI of the LAD CTO.
During the procedure, the operators conducted a double injection (RCA with AL 7F side hole, LAD EBU 7 F). They first accessed the diag (simple microcath and XT wire) and then the LAD (double-lumen microcath). Subsequently, they placed a stent (3.5-38 mm) in the proximal section of the LAD with diagonal kissing, and 1 stent (3.0-28 mm) in the mid part of the LAD, which was prepared with a cutting balloon and guided by IVUS.

LIVE case from Sunninghill Hospital, Johannesburg - South Africa

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Key moments

• 09:10-22:15 - Anterograde CTO of diagonal and LAD with a double-lumen microcatheter
• 37:23-40:00 - Stabilisation of ostial LAD stenting with a balloon in parallel
• 54:30-01:01:04 - IVUS control

Keywords: Anterograde LAD CTO, non-left main bifurcation, provisional stenting, IVUS, cutting balloon