Deep intubation technique for Complex Percutaneous Coronary Intervention. Insights of a feared and harmless technique

Background: A successful percutaneous coronary intervention (PCI) on complex coronary anatomy can be up to 90% of cases and depends on many factors such as successfully guiding catheter support, which entails a perfect entry in the ostium of the treated artery, the guidewire ́s ability to cross the culprit lesion and the stent profile. In some transradial artery cases the vessel ́s diameter does not allow the use of a thick guiding catheter (from 6 to 8 Fr), in these cases special techniques such as “deep intubation” may be useful, if performed correctly. Methods: We describe four different percutaneous coronary interventions (PCI) scenarios related to stent delivery in difficult procedures involving saphenous vein graft, mammary artery graft and native coronary arteries in complex anatomies with no incurring complications. Results: Interestingly, deep-intubation has been considered a dangerous and contraindicated procedure to perform through coronary angioplasty, nonetheless we found that in many cases the deep intubation technique is an effective and convenient procedure when performed with small sized catheters at low cost. SCIREA Journal of Health http://www.scirea.org/journal/PMH