Recanalization of a complex RCA CTO using Antegrade/Retrograde Approach – Oct 2019

50-year-old female with multiple CAD risk factors presented with new onset CCS Class II angina for two months and stress echo revealed moderate inferior ischemia. A Cardiac Cath on October 7, 2019, performed at an outside hospital, revealed 1 V CAD: CTO of prox RCA, which fills via collaterals from left system with non obstructive left system, SYNTAX Score of 9 and LVEF 60%. The RCA CTO is long and calcified with J-CTO Score of 4. Patient is now planned for PCI of RCA CTO using rotational atherectomy and stents via antegrade approach and if failed, then retrograde approach.


Suggestions


Imaging Guided Calcified LM PCI with Interactive Discussion about EXCEL Trial Results by Dr. Gregg Stone and Dr. John Puskas – November 2019
Tags: Complex coronary | excel trial | left main intervention | Rotablator

Case and Plan: 77 year-old male with stable class II angina and exertional dyspnea was noted to have calcified 90-95% left internal carotid artery stenosis on carotid duplex for ongoing neurological symptoms. A Cardiac Cath on November 18, 2019 as the part of pre-op evaluation for carotid endarterectomy revealed calcified severe 2V (RCA and LCx) […]


Impella Assisted Protected Multivessel PCI using Rotational Atherectomy – Sept 2019

62-year-old male presented with new onset Class III angina, NIDDM and positive MPI for multivessel ischemia in inferior, lateral and anterior walls. A Cardiac Cath on September 6, 2019 revealed 3V CAD: 100% proximal RCA, 80% calcified proximal LAD/D1 bifurcation Medina (1,1,1), calcified 80% mid LAD, calcified diffuse subtotal LCx-OM2 with SYNTAX Score of 39 […]


FFR & OCT Guided Staged PCI of LAD Diagonal Bifurcation – Aug 2019
Tags: Bifurcation | Complex coronary | LAD

50-year-old female with new onset Class II angina and strongly positive stress MPI for multivessel myocardial ischemia with TID. A Cardiac Cath on June 26, 2019 revealed 3V CAD: 70% severely calcific prox LAD with diagonal bifurcation, 80% LCx-LPL, 80% mid RCA with SYNTAX Score of 23 and LVEF of 60%. Patient underwent successful DES […]


Complex PCI of 20 year old multiple CTO Lesions of RCA – July 2019
Tags: Antegrade Approach | Chronic Total Occlusion (CTO) | Retrograde Approach

Case and Plan 82-year-old female with NIDDM and prior CABG (1998) & PCI’s presented with CCS Class III angina and high-risk positive stress MPI for multivessel ischemia and normal LV function. A Cardiac Cath on May 21, 2019 revealed III Vessel CAD with totally occluded mid-distal RCA, prox LAD and LCx-OM1, 90% native distal LAD […]