- Patient initials or identifier number:
-Relevant clinical history and physical exam:
This 63 years old male had underwent CAG at 27th, March, 2020 as combine CAG with TFCA due to CVA.At that time, 3VD was noted, but PCI to LCX was failed. We planned follow up CAG for this patient at 11th, September, 2020.He showed no chest pain or dyspnea and his functional capacity was good.
-Relevant test results prior to catheterization:
He had medications for hypertension, diabetes mellitus and dyslipidemia.His ECG showed sinus rhythm with RBBB and echocardiographic finding was tolerable with normal LVEF and no RWMA.
- Relevant catheterization findings:
Previous CAG at March, 2020 revealed 3VD.I planned to performed PCI to OM bifurcation and diagonal branch. (video 1)I tried wiring to OM but microcatheter was not able to enter OM. (video 2)I pushed some contrast through microcatheter to see the catheter was in true lumen, but dye staining was observed and OM flow was totally occluded.I tried re-wiring to OM many times, but eventually failed wiring and decided to perform re-look CAG after 6 months. (video 3)