Doctor & Patient Education Cardiac Specialist Centre
Intervention
1. A case of RCA CTO
Technique of Deep seating of catheter to deliver stent
  • This patient presented with total occlusion of the right coronary artery.
  • The procedure was carried out via the right radial access.

The baseline angiography shows a long blockage

2 prox balloon anchor - Due to inadequate support from the guiding catheter...

4 deep seating of guide - Very poor support from guiding catheter

Due to extreme lack of support from guiding catheter, delivery of stent was not possible. To overcome this problem, a distal anchoring balloon was deployed and extreme deep seating of guiding catheter was achieved.

Stent deployed

With the deep seating of guide, stent is able to be deployed in the RPL branch

After successful stent implantation the RCA is fully opened



CONCLUSION
  • When support of guiding catheter is inadequate.
  • The options can be to change to a different shape guide, but this will incur cost.
  • One can change to femoral approach, but this will cause extra pain and cost.
  • Deep seating of guide is commonly used, but such deep seating requires more care and skill to achieve.
  • A complex case can still be successfully completed via radial access.
Consultation
Know Your Cardiologists

I feel breathless when walking.

I feel a tightness over my chest.

Do I need to take my medicine for my blood pressure?

Do I need to take my medicine for my cholesterol?

Do I really need stents for my artery?

Do I really need to have a bypass operation?

When should I go for health screening?

I have heart problem, can I take Viagra?

I have heart problem, should I exercise?

Heart Disease
Learn about your heart Conditions

You may need an ultra sound scan of your heart to assess its function.

You may need a treadmill stress test.

You may need closer monitoring.

You may need a more thorough risk assessment and life style change.

You may only need to take your medicine.

You may get away with just stenting.

This generally should start at 40 years old.

Yes, but there are certain strict conditions to fulfill.

Yes, but you will need to find out the appropriate intensity.