Algorithm for channel crossing.


Firsrt wire
Second choice small channel
Second choice for tortuous channel
Third choice for tortuous channel
L->R septals Selective injection* Further distal selective injection with rotational angiogram SIon XTR Suoh 03 Sion Black
R->L Septals Non selective injection (or via twin lumen) Twin lumen catheter to overcome retroflex ostium Sion XTR Suoh 03 Sion Black
Epicardial Selective injection* Microcatheter follow wire technique Suoh 03 XTR/Sion Sion/XTR Sion Black if large epicardial channel.
  • Selective angiography should be done with biplane or rotational angiogram.