Video Supplement to “Challenging Aorto-Coronary Occlusion: Which Solution?" [January 2019 Clinical Images article by Lorenzoni, et al.]
An 86-year-old woman was rescued by the emergency team for inferior STEMI complicated by cardiogenic shock. Echocardiogram showed severe dilation of the right ventricle with compromise of its ejection function. It was impossible to perform a retrograde approach or plaque debulking as described in the literature; this is the first description of the use of a microcatheter not to support the guidewire, but to open an aorto-coronary calcific occlusion with anterograde approach in an emergent situation. The subsequent result is shown in the angiographic video below.