fig2
Figure 2. A:heavily calcified mid RCA CTO; B: epicardial collateral (yellow arrows) from LCx was navigated wih Sion Black wire; C: then CTO was crossed retrograde with Gaia 3 wire that re-entered in right guiding catheter but the microcatheter wasn’t able to cross retrograde depite double trapping; D: clinical destabilization suddenly occurred with chest pain and hypotension: angiography showed LM dissection with LAD occlusion (circle); E: LM-LAD stenting after LAD wiring; F: final angiographic result: patency of LAD and LCx, aborted CTO PCI. CTO: chronic total occlusions; RCA: right coronary artery; LAD: left anterior descending; LCx: left circumflex; LM: left main