Iliac CTO Masterclass: Access, IVUS, Re-Entry, IVL, and Stent Strategy with Dr. Jay Mohan and Dr. Sameh Sayfo

Iliac CTOs are among the highest-risk, highest-reward procedures in peripheral intervention. In this MurmurMD session, Dr. Jay Mohan joins Dr. Sameh Sayfo to break down their full approach — from diagnosis and CTA planning to crossing strategies, re-entry methods, IVUS, vessel prep, and stent selection.This case-driven conversation is packed with pearls on how to handle complex iliac occlusions safely and predictably.What you’ll learn from this transcript-based discussion:• Why PVR and waveform analysis matter more than ABI alone• CTA essentials: calcium burden, aorto-iliac disease, access planning• Jay’s preferred dual-access setup (radial + ipsilateral femoral)• When to start anti-grade vs retrograde — and how to choose the correct cap• Safe knuckling with microcatheter support through the CTO• How to externalize the wire and complete the case through femoral access• Why “every iliac should be IVUS”• IVL in the iliac system: M5+, L6, Javelin, and how vessel size determines device choice• Covered vs uncovered stents (VBX, ICAST, Lifestream, Visi-Pro)• Why balloon-expandable covered stents dominate TASC C/D and CTO lesions• When to use kissing stents and when to avoid self-expanding at the common iliac ostium• Rescue toolkit: covered stents, bright-tip sheaths, alternative access, balloon tamponade• Why Pioneer re-entry is less common now — and how R2P changed the gameA must-watch for operators who want to sharpen their iliac CTO algorithm and device selection.🔔 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 – Why iliac CTOs are high-risk, high-reward lesions 01:00 – Symptoms, ABI/PVR, waveform interpretation 02:00 – CTA planning: calcium, inflow disease, access strategy 03:00 – Choosing access: radial + ipsilateral femoral 04:00 – Anti-grade vs retrograde crossing strategy 05:00 – Knuckling technique and microcatheter support 06:00 – Re-entry options: R2P vs Pioneer 07:00 – IVUS: why “every iliac should be IVUS” 08:00 – Vessel prep: M5+, L6, Javelin, and when each matters 09:00 – Stent selection: covered vs uncovered, ostial precision 10:00 – Kissing stents and hybrid approaches 11:00 – Rescue toolkit: perforation, sheath size, balloon tamponade 12:00 – Final pearls for early operators#PeripheralIntervention #IliacCTO #IVL #IVUS #Endovascular #ComplexPCI #PeripheralArteryDisease #MurmurMD #VBX #ICAST #R2P #CoveredStents