Episode # 3 • 16 Sept 2025
Navigating Coronary Tortuosity in Complex Interventions
How do you navigate tortuous coronary vasculature? In this episode of BackTable Cardiology, Dr. Hady Lichaa hosts Dr. Alexander Truesdell, an interventional cardiologist with extensive experience in overcoming complex cases of vessel tortuosity.
Timestamps
00:00 - Introduction
02:07 - Approaching Cases of Extreme Tortuosity
14:04 - Defining Tortuosity of the Coronary Vessels
18:40 - Guide Size and Equipment Strategy in Complex PCI
35:04 - Distal Guide Extension Catheter Use and One Potential Risk
43:16 - Using Imaging Catheters
49:25 - Discussion of Avoiding Complications
57:40 - Selecting Stents
01:04:00 - Guide Extension Use Through Pseudo Lesions to Decrease Ischemic Time
01:11:00 - Parting Advice for New and Mid-Career Interventional Cardiologists
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More about this episode
Beginning with Dr. Truesdell’s background and expertise, the discussion delves into best practices for evaluating and navigating tortuous anatomy both diagnostically and interventionally, the use of various wires, guides, and support techniques, and how to effectively use imaging and atherectomy tools. They also touch on practical aspects of tackling coronary tortuosity, like procedural preparation, equipment choices, and the importance of continuous learning in an evolving area of medicine.
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