IMS & SUM Hospital Successfully Performs Complex LAD CTO Revascularization

BHUBANESWAR, India - Dec. 1, 2025 - PRLog -- The Department of Cardiology at IMS & SUM Hospital has reported the successful revascularization of a long-segment chronic total occlusion (CTO) of the left anterior descending artery (LAD) in a 45-year-old male who presented with inferior wall myocardial infarction and complete heart block.
The patient initially underwent primary PCI to the right coronary artery (RCA). Subsequent angiography revealed 100% occlusion of both the LAD and LCX, necessitating a separate, technically demanding CTO intervention.

Procedure Overview

The LAD CTO posed significant challenges due to its length and proximity to diagonal and septal branches.
Dr. Nayak utilized an antegrade wire escalation strategy to cross the lesion, employing:

• Gaia 3
• Miracle 6
• Conquest Pro 12

Once the occlusion was crossed, the procedure was completed by de-escalating to a workhorse wire, enabling safe revascularization.

Outcome

The intervention resulted in successful LAD opening, with no complications and no side-branch occlusion.
The patient remained stable post-procedure, and the angiographic result was reported as satisfactory.

Clinical Perspective

"CTO PCI remains a highly demanding area of interventional cardiology. Accurate case selection, anticipating potential complications, and preparing bailout strategies are essential to achieving safe outcomes,"
said Dr. Gyana Ranjan Nayak, commenting on the procedural challenges.

Acknowledgment
The staged intervention was performed under the care of Dr. Gyana Ranjan Nayak, Interventional Cardiologist in Bhubaneswar (https://www.drgyana.com/), with support from the cardiology team.
The hospital recognized the coordinated work of senior colleagues, residents, and support staff.
Dr. Nayak also acknowledged insights gained from Dr. Okamura in the field of angiographic 3D wiring, which contributed to enhanced procedural clarity during CTO interventions.

About IMS & SUM Hospital

IMS & SUM Hospital, Bhubaneswar, is a tertiary care teaching institution providing multidisciplinary clinical services, including advanced interventional cardiology.