Antegrade CTO PCI

Doctor Roberto Garbo
Prof. Roberto Garbo

Maria Pia Hospital, GVM Care & Research, Turin, Italy. Director of CTO and Complex PCI Program.

Patient profile

  • Patient 69 years old and male.
  • Risk factors: Smoker, hypertension and diabetes.
  • In 2018 he presented an effort angina treated with DES on LAD, prox LCX CTO, prox RCA in stent CTO.
  • In 2019 failed attempt to recanalize RCA and CX.
  • In 2020 he presented angina at rest.

Lesion type

  • A prox-Mid LAD/ Dg subocclusion, RCA and LCX CTO was detected (Figure 1).
  • Prox LCX CTO PCI was schedule the 26th of March 2021.

Procedure

  • This para-ostial Circumflex CTO with previous failed attempt was treated by antegrade approach with Navitian 135 cm and Gaia 3rd.
  • Navitian advance easy in front of the prox cap (Figure 2).
  • We obtained very good crossing with Gaia 3rd (Figure 3,4) followed by easy crossing by the Navitian (Figure 5).
  • After stenting, we obtained a good final angiographic result (Figure 6).

Conclusion

“The feedback about Navitian is good, with interesting behaviour in crossing the Circumflex calcified CTO body following Gaia 3rd.”

Prof Roberto Garbo, Maria Pia 
Hospital, Turin, Italy

Figures
FIgure 1. LCX CTO
FIgure 1. LCX CTO
Figure 2. Navitian 135 in front of prox CAP
Figure 2. Navitian 135 in front of prox CAP
Figure 3. Navitian 135 and Gaia 3rd advance in prox LCX tortuosity
Figure 3. Navitian 135 and Gaia 3rd advance in prox LCX tortuosity
Figure 4. Gaia 3rd crossing CTO
Figure 4. Gaia 3rd crossing CTO
Figure 5. Navitian crossing CTO
Figure 5. Navitian crossing CTO
Figure 6. Final angiographic result
Figure 6. Final angiographic result
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