Iliac CTO Case Series: Radial R2P, Externalization, IVUS, and Covered Stent Strategy with Dr. Mohan and Dr. Sameh Sayfo

Iliac CTO interventions follow patterns — but recognizing them in real time is what separates a difficult case from a controlled one.In this MurmurMD case discussion, Dr. Jay Mohan and Dr. Sameh Sayfo walk through two iliac CTO interventions, highlighting practical lessons in access strategy, crossing techniques, IVUS guidance, and covered stent deployment.Key concepts discussed directly from the transcript include:• Why ABI can appear normal despite severe inflow disease• Using waveform analysis and CTA to guide planning• When femoral access fails — and why radial R2P changes the game• Recognizing the true stump and avoiding false lumen escalation• Externalizing the wire and advancing destination-style sheaths• IVUS (014 vs 018) for accurate vessel sizing• Bilateral kissing covered stents in complex aorto-iliac anatomy• Managing aneurysmal segments and knowing when to consider EVAR• Using a misplaced wire as a roadmap instead of removing it too early• Covered stent strategy to manage large dissections safelyTwo real-world cases. One disciplined algorithm. A practical discussion for anyone treating complex iliac disease.🔔 Subscribe for more insights from interventional experts and real-world program builders.📱 Download the app: https://apps.apple.com/app/apple-store/id1586692687📺 Follow us on YouTube: https://www.youtube.com/channel/UCfrLYhAhliQ2ZvXinkDCZvAChapters:00:00 – Introduction: Recognizing iliac CTO patterns 00:30 – Case 1 overview and waveform clues 01:10 – CTA review and identifying the true stump 01:40 – Femoral access failure → switching to radial R2P 02:20 – Crossing strategy and wire externalization 03:00 – IVUS sizing and covered stent selection 03:40 – Bilateral kissing stents and aneurysm considerations 04:20 – Case 2 overview: prior stent and new CTO 05:00 – False lumen wire as a landmark 05:40 – Radial crossing and externalization 06:10 – Managing dissection with covered stents 06:40 – Final results and key takeaways#PeripheralIntervention #IliacCTO #IVUS #CoveredStents #Endovascular #R2P #PeripheralArteryDisease #MurmurMD