EuroPCR2026-images-105181-Quo-vadis

What does the image show?
Stent within the LAD
Calcification in the LAD CTO
Covered stent straddling LAD CTO and extra-coronary area
Correct! The correct answer is "Covered stent straddling LAD CTO and extra-coronary area".
 
During the attempted CTO PCI procedure, the wire was deflected at the point of calcification and re-entered distally- this was not noted on the angiogram and the microcatheter followed the wire. Following this a massive perforation occurred and a covered stent was implanted. At follow-up the patient had atypical chest pain and a CTCA was performed which shows the covered stent outside the main LAD bridging the LAD CTO. The patient was managed medically.

 
Good try! The correct answer is "Covered stent straddling LAD CTO and extra-coronary area".
 
During the attempted CTO PCI procedure, the wire was deflected at the point of calcification and re-entered distally- this was not noted on the angiogram and the microcatheter followed the wire. Following this a massive perforation occurred and a covered stent was implanted. At follow-up the patient had atypical chest pain and a CTCA was performed which shows the covered stent outside the main LAD bridging the LAD CTO. The patient was managed medically.
 
 
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