Case Sharing: A Case of Successful Crossing of a Calcified Lesion using 3D Wiring in CTO-PCI
Dr. Atsunori Okamura, Sakurabashi Watanabe Hospital
Background
Since the introduction of PCI in 1977, 2D wire manipulation of coronary arteries, which are 3D structures, has been continuously performed.
Even today, the method of manipulating the wire-tip load in a stepwise fashion has become the standard and has not progressed out of the realm of mastery.
About 10 years ago, we established the 3D wiring method, in which a 3D wire is manipulated in a 3D coronary artery in all PCI procedures including CTO-PCI, to accurately capture the target from 140 cm away.
The 3D wiring method in Sakurabashi Watanabe Hospital over the past 10 years
1. IVUS specialized for CTO
- Okamura A. Catheter Cardiovasc Interv. 2010; 75: 1062-1066
- Okamura A. Cardiovasc Interv Ther. 2014; 29: 181-186
2. Angio-guided 3D wiring technique
- Okamura A. Cardiovasc Interv Ther. 2016; 31: 238-244
- Tanaka T, Okamura A. JACC. Intv. 2019; 12: 545-555
3. IVUS-guided 3D wiring technique
- Okamura A, Nagai H. JACC. Intv. 2020; 13: 67-75
- Tanaka K, Okamura A. JACC. Intv. 2020; 13: e69-e70
- Suzuki S, Okamura A. JACC. Case Rep. 2020;2:961-965
- Suzuki S, Okamura A. JACC. Intv. 2021; 2021; 14: 812-814
IVUS-guided ADR
- Okamura A, Nagai H. Cardiovasc Interv Ther. 2022, doi.org/10.1007/s12928-022-00846-2
3D wiring: Direction control with 3D image using a Conquest-12g (1mm, 45º)
Case
Male in his 70s
Diagnosis: Effort angina pectoris
Risk Factors: Diabetes mellitus, Hypertension, Hemodialysis（11 years）
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