A 67 year old man with a history of diabetes mellitus, hyperlipidemia and hypertension was evaluated for stable angina and evidence of inducible inferior myocardial ischemia.

The coronary angiogram showed two-vessel disease involving right coronary artery and bifurcated lesion located at circumflex-left obtuse marginal. After PTCA and stenting of right coronary artery, the circumflex-left obtuse marginal bifurcation [angle < 85° in left anterior oblique caudal view showing the biggest divergence between two branches (figure 1)], was treated by using the new VENTURE™ catheter (St. Jude Medical, MN - USA). VENTURE™ is an Over The Wire (OTW) catheter single lumen sheath with radiopaque deflectable distal tip to support and orientate wires (figure 2) in total or subtotal occlusions and in vessels with severe tortuosity near the lesion. The catheter (140 cm length) is compatible with 0,014” guide wires and 5F and larger guiding catheters. It was impossible with conventional technique to put a wire across the sub-occlusive lesion of the left obtuse marginal branch for the very sharp take-off from the circumflex. We used the VENTURE™ catheter to negotiate the short angle between circumflex and left obtuse marginal to wire the left obtuse marginal branch (figure 3.A). Through the VENTURE™ catheter a Choice PT Floppy 0,014” wire...continua a leggere