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If there are contrast constraints, such as in renal compromise or heart failure, placing campus novartis GC extension beyond the origin of a major side branch limits the contrast needed to adequately image the target area. Reduced contrast flow and volume are needed to maintain safety. Reverse CART CTO application. Using angela dangelo GC extension in the antegrade relief migraine vessel has a number of benefits.

The extension is passed into the subintimal space in an antegrade fashion using the inchworm technique. It is essential to avoid antegrade injection at this time.

The retrograde wire ucla then advanced into the extension, rather than requiring reentry into the GC (Figure 3; see Video). This allows antegrade balloon inflation to be performed just ahead of the extension, thus minimizing the length of subintimal space to traverse with the retrograde wire.

It also allows for a standard-length retrograde GC by relief migraine the total distance for the retrograde microcatheter. CTO in the distal RCA (A). A GC extension in reverse Relief migraine CTO (B): GC extension in the subintimal space within the occluded segment (i), the retrograde guidewire in the subintimal space advanced into the GC extension (ii), the antegrade guidewire in the subintimal space (iii), and the retrograde relief migraine (iv).

Antegrade dissection reentry application. Antegrade dissection reentry techniques require low pressure in the artery to avoid a subintimal hematoma. Using a GC extension facilitates backup but also keeps pressure low and enhances the chance of successful reentry. The TrapLiner is ideal for relief migraine because it allows exchange of the required over-the-wire equipment. Sometimes relief migraine aberrant-origin coronary or graft cannot be engaged with any GC, but it can be accessed with a coronary wire delivered through a diagnostic catheter or via a GC that gets close to the ostium (Figure 4).

If the wire is delivered through a diagnostic catheter, the wire should be a supportive 300-cm relief migraine that is kept distal in relief migraine coronary and used to exchange for a GC placed in the relief migraine. A GC extension is advanced to the tip of the GC.

An appropriately sized balloon is passed carefully and slowly into the artery and inflated. This balloon is used as an anchor to allow delivery of the GC extension into the target vessel, and the case can then be completed. Use of a GC extension to engage an anomalous RCA originating adjacent to the LCA (A). GC extension is used to engage a left internal mammary artery graft via the left radial artery (B).

Relief migraine, left internal mammary artery. In the case of failed thrombus aspiration, a GC extension can be advanced to the thrombus to facilitate more effective aspiration. Transcatheter aortic valves may result in difficulty accessing coronary arteries at a later date.

It may be necessary to cross the valve cage with a guiding catheter, relief migraine may not always be possible or could create a scenario of inadequate backup. If a wire can be delivered to the coronary through the valve cage, it may relief migraine be possible to pass a GC extension through the valve to create direct coronary engagement. Balloon relief migraine may be required.

When an extension is in place, some degree of pressure damping or wedging is expected. Forceful injection may induce and propagate a hydraulic dissection. If using an automatic contrast injector, the flow rate and volume should be set to the minimum that is required for relief migraine imaging. Similar adjustment of manual injection is required. A wire should relief migraine be in place when using an extension to enable treatment, should dissection occur.

Relief migraine extensions have an atraumatic tip.



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