Author + information
- Mahmoud Mohamed Soliman1
Patient initials or identifier number
Relevant clinical history and physical exam
68 years old male patient
Compliant from typical chest pain at rest with optimal medical therapy
cvRF: Ex-Smoker, Hypertension, Diabetic
P H: Inferior MI and received SK at 2008
ECG: Pathological Q in Inferior Leads and ST depression in V4-V6, AVL
ECHO: LVEF 48%, Hypokinesia in the Apical, Anterior and Lateral Walls.
Index Coronary Angiogram: 3-vessel disease. Total LAD and Subtotal LCX and mid-segment RCA
We use 6FGuiding Catheter
Pilot 200 wire and Maverick balloon 2.0x20 mm
we have dissection after good dilatation we use Xience DES 2.75x 38 mm and Nobori 3.0x 28 mm DES
Must do CTO as the results of it is so good and we take chance to do it with minimum risk to the patient
Must believe that treating CTO is the correct thing to do.
Predilataion and good preparation of the lesion.
Successful PCI of a CTO lesion is associated with better symptomatic outcome, a reduced need for CABG, a lower rate of major adverse cardiac events at 12 months and improved survival when compared with unsuccessful attempts
Improved survival include improved LV function, reduction in risk of ischemia-related malignant arrhythmias and better tolerance of contralateral coronary occlusion