CHRONIC TOTAL OCCLUSION OF INFRA RENAL AORTA- SKS STENTING

Dr Sreenivas Reddy, Dr Ajit KulkarniDr Nishant, Dr SaujithyaDr Nishant, Dr Saujithya

Department of CardiologyPGIMER, Chandigarh, g

45/m Smoker Claudication of Bilateral lower limbs for 1 year Claudication of Bilateral lower limbs for 1 year CT angiogram: Chronic total occlusion of Infrarenal

abdominal aorta and Illiac arteries filling from gcollaterals

Bilateral femoral and Left Brachial accessJR diagnostic catheter 6F Contrast injection shows JR diagnostic catheter 6F, Contrast injection shows Infra renal aorta cut off

JR, 6F Guiding catheter, Terumo 0.035” glide wire corssed the lesion through sub intimal approach into corssed the lesion through sub intimal approach into the left Illiac artery

Similarily 0.035 ” terumo J tipped glide wire crossed the lesion into the right Illiac arterythe lesion into the right Illiac arteryThe glide wire exteriorised

The lesion prediated with 5.0x 60 mm Advance LP Cook balloon in the left CIA

The lesion prediated with 6.0x 40 mm Advance LP Cook balloon in the right CIA

The lesion prediated with 6.0x 40 mm Advance LP Cook balloon in the right CIA

Smart control Nitinol stent (cordis) 8.0x120mm positioned in the aorta across the right common illiacpositioned in the aorta across the right common illiacartery

Second Smart control Nitinol stent (cordis) 8 0x150mm positioned in the left Illiac atery into the 8.0x150mm positioned in the left Illiac atery into the aorta

Simultaneous Kissing stenting done Simultaneous Kissing stenting done

Post stent dilatation done with 8.0x40 mm Optraballoon (cordis) in the left Illiac artery

Post stent dilatation done with 8.0x40 mm Advance LP balloon (cordis) in the left Illiac artery

Final Kissing Balloon InflationsFinal Kissing Balloon Inflations

Excellent flow Excellent flow

DiscussionDiscussion

approach to chronic total occlusion sub intimal approach SKS stenting SKS stenting