Angioplasty Procedure

Strategy: Notice that there is a long left main with almost right angled origin of circumflex this kind of an anatomy needs excellent back up. An average wire may continue to prolapse into the LAD particularly if there is an angulation in the proximal circumflex. Here choice of guide catheter should be either extra backup EBU, or VODA curve (Boston scientific). In my experience hydrophilic wire is ideal for a lesion like this. Notice that angulation of each curve of tortousity with in the lesion is very small and therefore wire was shaped at a distance of only 1.0-2.0 mm from the tip. A sharp bend was created with the tip of the needle. It is possible that one may have to change several wires and therefore over the wire balloon is an appropriate choice

Please Note: In presence of the balloon support use of force injudiciously on the wire could result into dissection.