Case 92: PCI Manual - PCI of last 2 remaining vessels

A patient with ischemic cardiomyopathy, prior CABG, and chronic kidney disease presented with recurrent ICD shocks. He had a severe lesion in the ramus and in the ostium of the right posterior descending artery. A decision was made to recanalize both lesions using hemodynamic support with an Impella device. The ramus was predilated and stented without difficulty, however wiring the PDA was challenging and could not be achieved despite using various guidewires (Sion blue and Whisper), with different bends at the tip and use of a Corsair microcatheter. Using a lateral projection the PDA was successfully wired and stented without any complications.