Case 95: PCI Manual - STEMI and unable to engage
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- Опубліковано 22 сер 2024
- A patient presented with inferior ST-segment elevation acute myocardial infarction. The left main was initially injected showing lesions in the LAD and circumflex. The RCA could not be engaged with a JR4 catheter. Cusp angiogram showed some filling of the RCA but the ostium could not be localized. Eventually the RCA was engaged with a multipurpose catheter: it had a superior and inferiorly directed take-off. Balloon angioplasty, followed by aspiration thrombectomy and stenting were performed with an excellent final result.
I love this video so much. I see this video once or twice a month haha
Thanks. Actually in my experiency I did have more low abnormal RCA take offs..
Great real world case... thank you!
Thank you for your nice sharing.
excellent case. thank you. What guides do you prefer? I get better support with AL 2 guide in this kind of cases
I have a similar case , thanks for tips
Thanks. Nice case. I Can see part of the thrombus is dislodged to the distal RCA before the crux.. Any plan for GP IIb. IIIa antagonist IC or IV?
Could that sort of RCA also have been engaged by 3DRC guiding?
Did you have issues while tracking the thrombuster, stent etc? What would you suggest for more guide support.
Longer sheaths if coming from femoral access or guide extensions. In this case probably guide extensions given the way the catheter is sitting (if poor support).
were you concerned about the haziness at 6 30 PM on final picture angiogram? IVUS?