The same technique was applied to deploy a second DES proximally to the first one (3.5 × 28 mm on proximal segment). During slow deflation of the balloon, the Guidezilla™ catheter (5-in-6 Fr) was advanced distal to the proximal stenosis to be stented, thus allowing a first drug eluting stent (DES) 3.5 × 48 mm to be placed on the mid-distal segment of the graft according to a LSD technique. Then, the use of distal anchoring balloon warranted support and tracking, made as centring rail for the advance of the tip of the “mother-and-child” catheter into the SVG. An elective PCI of SVG on RCA with rotational atherectomy was performed (left radial approach, 6 French). After several attempts, the procedure was interrupted with a suboptimal result (Fig. The proximal calcified stenosis has been crossed with a 1.5 x 12 mm balloon only with the support of Guidezilla™ guide extension catheter (5-in-6 Fr), however the non compliant (NC) balloon 2.5 x 15mm was unable to break the hard and calcified plaque (Fig. Left internal mammary artery on the mid left anterior descending artery was patent. 1a) and an ostial stenosis of the SVG on first obtuse marginal branch (OM1). Grafts angiography showed a tandem calcified lesions of SVG on distal right coronary artery (RCA) (Fig.
Native coronary circulation was completely occluded at the proximal segments. Baseline values of Hs-Troponin T and CK-MB were 497 ng/l and 211 U/l respectively. During slow deflation of the balloon, the Guidezilla™ was advanced distal to the stenoses to be stented, thus allowing the placement of two long drug eluting stents according to a LSD technique.Ī 70 years-old man with a dilated ischemic cardiomyopathy, triple coronary artery bypass grafting (CABG) in 1990 and chronic renal failure (baseline GFR: 45 ml/min/1.73 m 2) underwent a coronary angiography for a Non-ST segment elevation myocardial infarction (NSTEMI). Two runs with 1.25 mm burr and 2 runs with 1.5 mm burr were carried out. An elective transradial PCI of SVG on RCA with rotational atherectomy was performed. After several attempts, the procedure was interrupted with a suboptimal result. The proximal calcified stenosis has been crossed with a 1.5 x 12 mm balloon only with the support of Guidezilla™, however the non-compliant (NC) balloon 2.5 x 15 mm was unable to break the hard and calcified plaque. Grafts angiography showed a tandem calcified lesions of SVG on distal right coronary artery (RCA) and an ostial stenosis of the SVG on first obtuse marginal branch (OM1). A 70 years-old man with a dilated ischemic cardiomyopathy, triple coronary artery bypass grafting (CABG) in 1990 and chronic renal failure (baseline GFR: 45 ml/min/1.73 m 2) underwent a coronary angiography for a Non-ST segment elevation myocardial infarction (NSTEMI).
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