Difficulty in reverse wiring in the presentation of critical lesions of targeted calcified true bifu

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  This 83year-old female was admitted to our cath lab due to Non-ST elevation myocardial infarction and received coronary angiography (CAG).The CAG revealed double vessels disease with bifurcation lesion (Medina 1,1,1) in junction of first diagonal branch (d1) and proximal to middle segment of left anterior descending artery (LAD) and severe stenosis lesions in middle and distal LAD and proximal right coronary artery (RCA).Due to the very acute angle of the bifurcation between d1 and LAD, it was very hard to wire to the d1.Therefore, we decided to do the reversed guidewire technique with adjunctive use of a double-lumen microcatheter.
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