Figure 4.

Case 2 coronary angiograms. (A) The right coronary artery (RCA) was engaged with a conventional Judkins left (JL) catheter (arrow). (B) The guidewire was unable to cross the lesion due to the non-coaxially engaged JL guiding catheter (arrow) with inadequate guiding catheter support (LAO view). (C) After modifying the JL catheter, engagement was coaxial (arrow) and the guidewire successfully crossed the totally occluded lesion (LAO view). (D) The final angiogram showed successful PCI (LAO view).