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  Indian J Med Microbiol
 

Figure 1: Cine angiographic views demonstrating “acute take off” of the LCX with percutaneous intervention using dual-lumen microcatheter. (a) RAO caudal view showing 40.3° angle between left main stem and LCX. LCX has proximal 95% discrete stenosis followed by 80% long-segment lesion with TIMI II flow distally, ramus has proximal 80% long segment stenosis. (b) LAO caudal view showing 42.8° angle between left main stem and LCX. (c) RAO caudal view showing Crusade (Kaneka), dual lumen microcatheter used to cross LCX lesion with two radiopaque markers, the distal marker represents the central lumen exit port while the proximal marker represents over the wire lumen exit port. The microcatheter positioned such that central lumen coronary guidewire, Sion (Asahi Intecc) is in ramus and over the wire lumen coronary guidewire Fielder (Asahi Intecc) is crossed into LCX. (d) RAO caudal view showing successful post-stenting results with two stents in LCX and one in ramus with TIMI III flow distally. (Measurements done by QCA analysis software; LAO: Left anterior oblique, LCX: Left circumflex artery, RAO: Right anterior oblique, TIMI: Thrombolysis in myocardial infarction)

Figure 1: Cine angiographic views demonstrating “acute take off” of the LCX with percutaneous intervention using dual-lumen microcatheter. (a) RAO caudal view showing 40.3° angle between left main stem and LCX. LCX has proximal 95% discrete stenosis followed by 80% long-segment lesion with TIMI II flow distally, ramus has proximal 80% long segment stenosis. (b) LAO caudal view showing 42.8° angle between left main stem and LCX. (c) RAO caudal view showing Crusade (Kaneka), dual lumen microcatheter used to cross LCX lesion with two radiopaque markers, the distal marker represents the central lumen exit port while the proximal marker represents over the wire lumen exit port. The microcatheter positioned such that central lumen coronary guidewire, Sion (Asahi Intecc) is in ramus and over the wire lumen coronary guidewire Fielder (Asahi Intecc) is crossed into LCX. (d) RAO caudal view showing successful post-stenting results with two stents in LCX and one in ramus with TIMI III flow distally. (Measurements done by QCA analysis software; LAO: Left anterior oblique, LCX: Left circumflex artery, RAO: Right anterior oblique, TIMI: Thrombolysis in myocardial infarction)