Amro Sayed

Thank you all for your comments, The challenges were : Acute presentation with inferior STEMI ( unfavorable gor surgeons) Diabetic with poor distal targets Young patients , so we need to preserve distal targets for future CABG as possible. stented distal RCA 3.5x33 DES , stented LCx 2.5x33 DES , ostial LAD till mid segment 2.75 x 44 DES postdilated with 3.5 NC high pressure , 2.5x25 NC for mid-distal RCA then DCB 40mm

This technique is used for distal wire perforation and you should embolize it just before the perforation .... any balloon 2 mm or more will do the job .... length 12 or 15 ... cut it into two halves and use the cut distal part as in the video

What will you discover in this module? * IVUS essentials * Various IVUS systems and catheters * Clock-face orientation and IVUS grayscale. * How to interpret your initial IVUS image. * Normal coronary artery appearance under IVUS. .

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The lesson here is ; always think of separate ostia if you don't see the suspected ostial occlusion ... disengage the GC and inject like in this case.

RCA reconstructed from ostium .... wire kept in the anomalous LAD to mark it 👇👇

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2)

Thanks all for the very valuable comments... I was working via dlTRA , 6F XB3.5 , my strategy for such case was Whisper extra support with a big 2ry curve and balloon support , pushing toward LAD and tried to make it to prolapse in LAD. it went with difficulty after some time.