Author + information
- Hotmauli Siahaan1
Patient initials or identifier number
Relevant clinical history andphysical exam
A 56 year-old male patient with history:
Was admitted to our hospital because of angina pectoris.
ECG : Inferior ischemia ,Echo: EF 65 %
Relevant test results prior to catheterization.
Relevant catheterization findings
Angiogram showed CTO at distal RCA.
Angiogram showed CTO at distal RCA (Figure1 ). PCI performed using an antegrade approach. After successful crossing with CTO wire, we tried to predilate with balloon 1.0 x 15 mm for several times, and continue to predilate with bigger balloon 1,5 x 10 mm and 2.2 x 10 mm.We tried to advance stent but failed to cross the lesion. We try to make support by angker wire (figure 2), but stent can't cross the lesion. So we decided to use mother and child technique with guiding catheter 7F and STO-1 5 F, we put the child catheter deep incubation within the proximal right coronary artery and pushed until close to the lesion (figure 3) and finally stent successfully crossed through the lesion and inflated up to 14 atm. Finally, the result was very excellent with no residual stenosis (figure 2).
Finally,the result was very excellent with no residual stenosis (figure 3).
Mother and child technique can be used as a maximal back up force on CTO lesions with calcified and angulation.
But we must be careful and aware of risks of dissection and air embolism.