ICIRCULATION：Thank you， with the increased experience and the development of devices， PCI of complex case such as chronic complete obstructed lesion has been performed by trans-radial approach gradually， but we all know that it is difficult to pass the lesion with guide wire for those cases during procedure. Would you like to share your experience about how to select the guide wire and other skills?

Georg Gaul: I don’t have much experience in the trans-radial approach， unfortunately， but I would like to know it. I do have some experience about the diagnostic catheter via the radial approach. With reopening of CTO， the only concern， again， in many of these cases， you need more than two stents to make it.

ICIRCULATION：One of serious complication of the trans-radial coronary intervention is the radial artery occlusion， so it is important to adequately assess the circulation issues in the hand before procedure. My questions are whether the Allen test is enough to assess， especially for diabetic patients.

Georg Gaul:  I am not an expert in the trans-radial approach， but as far as I know the Allen test is not that used any more by most experienced transradially working interventionalists. It’s only in rare case that they still do the Allen test now.

ICIRCULATION：Sometimes Failure of PCI by trans-radial approach is of weak guiding back-up， especially in complex lesion of RCA. At that time， how to overcome it and how to select the guide to provide the necessary guiding support during PCI.

Georg Gaul: This is a very good question. The weak guiding back-up may sometimes be overcome not only by finding a better guiding but also by using other opening techniques like the rotational atherectomy. Here you may work even with a very bad back-up and be able to reopen an artery.

ICIRCULATION：What do you think of the deficient with Chinese PCI? Could you give us some advice?

Georg Gaul: I think Chinese Intervention Society is already extremely experienced. With further improvement of the economic situation in China， even the management of the multi-vessel， multi lesion situation will become an everyday experience for Chinese interventionalists.