Complex & Imaging-Guided PCI
Procedure Steps
Some blockages are long-standing (CTO), involve main arteries, or are calcified. These need advanced techniques and imaging to ensure successful and safe stenting.
Chronic Total Occlusion (CTO) PCI:
Special wires and catheters cross a 100% blocked artery. Sometimes retrograde (via collateral vessels).
Left Main/Bifurcation PCI:
Two stents may be placed strategically to preserve blood flow.
Calcified Lesions:
o Rotablation: diamond drill to shave calcium.
o IVL (Shockwave): sound waves crack calcium for stent expansion.
Imaging (IVUS/OCT):
Tiny cameras/ultrasound inside arteries ensure stent is optimally deployed.
Physiology (FFR/iFR):
Pressure wire checks whether a blockage truly restricts blood flow.
