Figure 3.

(a) Bilateral injection shows an RCA-CTO with 47 mm length. During the first attempt, balloon dilatation in CTO body as a bailout technique was used. (b) Coronary angiogram during the second attempt shows CTO body more visible, at least in its first segment (arrowhead), and the CTO length was reduced to 28 mm as a consequence of SPM in the previous procedure. (c) The antegrade wire navigated subintimally, and by positioning the IVUS probe in subintimal space (arrowhead), a new wire penetrated into true lumen. (d) IVUS shows that the true lumen is compressed between 9 and 12 o’clock, and a new dedicated wire is being penetrated into true lumen (arrowhead). (e) Final angiographic result. CTO: chronic total occlusion; RCA: right coronary artery; SPM: subintimal plaque modification.