Fig. 2

Angiographic and intravascular ultrasound (IVUS) images. a and b Middle and distal left anterior descending arteries with 50–60% stenosis, distal Circumflex artery (CX) with 60% stenosis, and chronic total occlusion of the right coronary artery (RCA) from RCA ostium to the ostia of the posterolateral (PL) and posterior descending (PD) branches. c The guidewire is in the subintimal space (white arrow). d The SION™ wire is passed to the septal branch via a Corsair™ 150 tube, but the SION™ wire and the antegrade wire are not touching. e The SION™ wire is passed to the epicardial branch via a Corsair™ 150 tube, but the SION™ wire and the antegrade wire are not touching. f The Gaia Third™ wire appears to have passed the PD ostium under the plaque (white arrow) after use of the parallel-wire technique. g The real-time IVUS double-lumen microcatheter is advanced via a Gaia Third™ wire to find the true lumen before the ostia of the PD and PL branches, and the Conquest Pro™ wire is punched into the true lumen before the ostia of the PD and PL branches under the guidance of real-time IVUS. White arrow, Conquest Pro wire; black arrow, IVUS probe. h IVUS image showing the Conquest Pro™ wire punctured into the true lumen under the guidance of real time IVUS (white arrow). i The Conquest Pro™ wire is passed to the distal PD branch. j The final angiographic result was excellent. FL False lumen, TL Total lumen