Contrast modulation is also helpful for microchannel tracking RCA & LAD CTO. RCA has a microchannel but wasn't able to cross with multiple wires. Did Contrast modulation then it was crossed easily with PJ wire without tip bend. LAD was crossed with Gaia 3rd. Timi III flow.

Great case Imran. 👏🏼 Did you use contrast (modified Carlino) for both vessels? If so, did you save the injection images? Re: the RCA - I think contrast can facilitate crossing of established microchannels. Wonderful results. 👌🏼

Yes in both vessels. But unfortunately not saved for LAD. You are right contrast facilitates the wire crossing in the establishment microchannel. Maybe these are interrupted microchannels. You are being investigator and the author can elaborate on it better.

Excellent results sir. Great job done. Was this Carlino Technique for both..?

With guide only, its more luck, as you may raise a flap proximally. . Probaby better with microcatheter in lesion.

Not at all. MC was there. The contrast injection was through MC

Good job

Wow so interesting case but I hear first time about contrast modulation

Nicely done!

Whats contrast modulation?

What is contrast modulation? Please explain..