title: Ostial RCA intervention: guiding catheter challenges and use of a buddy wire to perform focused-force angioplasty on a severely calcific ostial right coronary lesion.
abstract: Ostial coronary disease presents a challenge from multiple perspectives with regard to percutaneous intervention. We present a novel case of a technically challenging ostial right coronary artery calcified lesion with a bar of calcium at the aorto-ostial junction which prevented intubation with multiple guiding catheters. We describe the use of a buddy wire as a technique for focused-force angioplasty with slow incremental balloon inflation of increasing diameter for plaque modification prior to stenting in a situation where rotational atherectomy and cutting balloon angioplasty were not an option.
authors.affiliation: St. Boniface General Hospital, University of Manitoba, Cardiology Department, Winnipeg, Manitoba, Canada, R3Y 1W7. farrukh7@mts.net
authors.forename: Farrukh
authors.initials: F
authors.lastname: Hussain
authors.forename: Tarek
authors.initials: T
authors.lastname: Kashour
authors.forename: Mahadevan
authors.initials: M
authors.lastname: Rajaram
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D017073:Atherectomy / Q000295:instrumentation / Q000379:methods*; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D015607:Stents