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Fig. 2 | BMC Cardiovascular Disorders

Fig. 2

From: Theory and practical based approach to chronic total occlusions

Fig. 2

The Parallel Wire Technique. a: Right coronary artery (RCA) chronic total occlusion (CTO); blunt proximal stump and bifurcation at the CTO site. b Contralateral contrast injection revealing CC2 septal and epicardial collaterals from the Left Anterior Descending (LAD) coronary artery. c Bilateral contrast injection with the distal vessel opacified indicating a short and straight occluded segment. d, e To prevent dislodgment of the guiding catheter while advancing wire and microcatheter through the occlusion, a 2.5 × 20 mm balloon is inflated in an atrial branch proximal to the occlusion (anchoring technique). The wire (Fielder XT, Asahi Intecc, Japan) made progress through the body of the occlusion but appears to have deflected from the target. f A Confianza Pro 12 wire (Asahi Intecc, Japan) supported by a Corsair microcatheter (Asahi Intecc, Japan) is advanced towards the distal end of the occlusion parallel to the Fielder XT wire which is left in place. At the insert the distal segments of the two wires. g Successful chronic total occlusion (CTO) crossing; dissection at the site of the occlusion after predilatation. g Final angiographic result after implantation of 3.5 × 38 mm and 3.0 × 38 mm everolimus eluting stents with (Thrombolysis In Myocardial Infarction) TIMI III flow and no residual stenosis

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