Journal: Europace
Article Title: Cardiac implantable electronic device upgrades and downgrades: a Clinical Consensus Statement of the European Heart Rhythm Association (EHRA) of the ESC, the Asia Pacific Heart Rhythm Association (APHRS), Canadian Heart Rhythm Society (CHRS), Heart Rhythm Society (HRS), and the Latin American Heart Rhythm Society (LAHRS)
doi: 10.1093/europace/euaf252
Figure Lengend Snippet: Venoplasty case example during an upgrade to CRT-P. ( A ) Pre-procedure venogram shows a venous stenosis interrupting antegrade flow, the presence of collateral vessels, then backfill up to the point of stenosis. ( B ) A KA2 hydrophilic guide catheter is used to cross the stenoses. ( C ) Venoplasty is then performed over a stiff Amplatz wire. A tight ‘applecore’ lesion is seen at the site of stenosis on the initial venogram, which is overcome by balloon inflation to 14 atm/14.18 bar. ( D ) This approach permits sufficient venous access to successfully deploy an LV lead.
Article Snippet: Alternatively, a hydrophilic angled braided guide catheter (for example the KA2 guiding catheter, Merit Medical, USA) can be utilized to provide direction and support for wire passage.
Techniques: