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How to avoid SB loss in CTO PCI


European Bifurcation Club 2018 – EBC 2018 – Brussels, Belgium

CTO and Bifurcation

How to avoid SB loss in CTO PCI

Author: Sunao Nakamura MD, PhD, New Tokyo Hospital 


Key Message 1 :

1. Retrograde technique is highly sure, reliable technique IF we have an appropriate collateral channel to use for it.

2. Condition of collateral channel is always changing and different in each procedure. And interestingly, even during the one procedure, collateral condition will sometimes change.

Key Message 2

In case of LAD no stump CTO, sometimes, we can not see the entry point by IVUS, because of the big space of LMT-LCX.

Key Message 3

In case of IVUS guided approach for guide-wiring to make sure for entering false to true lumen, we need “GUT Feeling” to put it in the true lumen.

Key Message 4

Coronary CT is significantly useful in reviewing lesion morphology and planning strategy. Sometime it may greatly change PCI strategy.

Most of LMT lesion involves bifurcation lesion. So we need … not only technique for CTO
but also sufficient knowledge of bifurcation PCI.


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