Iliac CTO Masterclass: Access, IVUS, Re-Entry, IVL, and Stent Strategy with Dr. Jay Mohan

Iliac CTOs are among the highest-risk, highest-reward procedures in peripheral intervention. In this MurmurMD session, Dr. Jay Mohan joins Dr. Sameh Sayfo to break down their full approach — from diagnosis and CTA planning to crossing strategies, re-entry methods, IVUS, vessel prep, and stent selection. This case-driven conversation is packed with pearls on how to handle complex iliac occlusions safely and predictably. What you’ll learn from this transcript-based discussion: • Why PVR and waveform analysis matter more than ABI alone • CTA essentials: calcium burden, aorto-iliac disease, access planning • Jay’s preferred dual-access setup (radial + ipsilateral femoral) • When to start anti-grade vs retrograde — and how to choose the correct cap • Safe knuckling with microcatheter support through the CTO • How to externalize the wire and complete the case through femoral access • Why “every iliac should be IVUS” • IVL in the iliac system: M5+, L6, Javelin, and how vessel size determines device choice • Covered vs uncovered stents (VBX, ICAST, Lifestream, Visi-Pro) • Why balloon-expandable covered stents dominate TASC C/D and CTO lesions • When to use kissing stents and when to avoid self-expanding at the common iliac ostium • Rescue toolkit: covered stents, bright-tip sheaths, alternative access, balloon tamponade • Why Pioneer re-entry is less common now — and how R2P changed the game A must-watch for operators who want to sharpen their iliac CTO algorithm and device selection. 🔔 Subscribe for more insights from interventional experts and real-world program builders. 📱 Download the app: https://apps.apple.com/app/apple-stor... 📺 Follow us on YouTube:    / @murmurmd   Chapters: 00:00 – Why iliac CTOs are high-risk, high-reward lesions 01:00 – Symptoms, ABI/PVR, waveform interpretation 02:00 – CTA planning: calcium, inflow disease, access strategy 03:00 – Choosing access: radial + ipsilateral femoral 04:00 – Anti-grade vs retrograde crossing strategy 05:00 – Knuckling technique and microcatheter support 06:00 – Re-entry options: R2P vs Pioneer 07:00 – IVUS: why “every iliac should be IVUS” 08:00 – Vessel prep: M5+, L6, Javelin, and when each matters 09:00 – Stent selection: covered vs uncovered, ostial precision 10:00 – Kissing stents and hybrid approaches 11:00 – Rescue toolkit: perforation, sheath size, balloon tamponade 12:00 – Final pearls for early operators #PeripheralIntervention #IliacCTO #IVL #IVUS #Endovascular #ComplexPCI #PeripheralArteryDisease #MurmurMD #VBX #ICAST #R2P #CoveredStents