A new understanding of chronic total occlusion from a novel PCI technique that involves a retrograde approach to the right coronary artery via a septal branch and passing of the guidewire to a guiding catheter on the other side of the lesion

2006 ◽  
Vol 68 (6) ◽  
pp. 907-913 ◽  
Author(s):  
Noriyuki Ozawa
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Chronic Total Occlusion ◽  
The Other ◽  
Retrograde Approach ◽  
Total Occlusion ◽  
Septal Branch ◽  
The Right ◽  
Guiding Catheter

scholarly journals Interventricular Septal Hematoma after Retrograde Intervention for a Chronic Total Occlusion of a Right Coronary Artery: Echocardiographic and Magnetic Resonance Imaging—Diagnosis and Follow-Up

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Makoto Araki ◽  
Tadashi Murai ◽  
Yoshihisa Kanaji ◽  
Junji Matsuda ◽  
Eisuke Usui ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Magnetic Resonance ◽  
Right Coronary Artery ◽  
Chronic Total Occlusion ◽  
Rare Complication ◽  
Interventricular Septum ◽  
Success Rates ◽  
Retrograde Approach ◽  
Total Occlusion

The reverse CART technique provides the potential to modify the retrograde procedure by improving the controlled movement of the retrograde wire and improve the success rates of percutaneous coronary intervention (PCI) of chronic total occlusion (CTO). Development of interventricular hematoma is a rare complication of CTO PCI. A 63-year-old man with effort angina with a right coronary artery CTO lesion underwent PCI by retrograde approach from the LAD to a septal branch. A contrast “stain” was demonstrated surrounding the septal collateral channel used for the retrograde approach at the end of the procedure without symptom. Echocardiography indicated an increased interventricular septum thickness with low echo signals region and decreased contractility. Cardiac magnetic resonance (CMR) imaging using gadolinium showed a diffusely thickened septum with a low signal fusiform neocavitation delimited by an enhanced-signal ring suggesting intraventricular septal dissecting hematoma. After conservative treatment, follow-up echocardiogram and CMR showed the resolution of the hematoma without clinical events. This case highlights the potentially lethal complication of septal perforator dissection and hematoma that may cause severe myocardial injury caused by retrograde approach for CTO PCI.

Tunnelling a calcified total occlusion

2021 ◽  
pp. 021849232110410
Author(s):  
Jogendra Singh ◽  
Dibyasundar Mahanta ◽  
Rudra P Mahapatra ◽  
Ramachandra Barik
Keyword(s):  
Coronary Artery ◽  
High Risk ◽  
Right Coronary Artery ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Alternative Technique ◽  
Total Occlusion ◽  
Alternative Approach ◽  
Calcific Plaque ◽  
The Right

Among the complex and high-risk coronary intervention cases, a calcified total occlusion of coronary artery poses a great challenge. We came across a 48 years old male who had calcified total occlusion of the right coronary artery. The chronic total occlusion was crossed using Nic-Nano balloon and the calcific plaque was modified using intravascular lithotripsy as an alternative technique to rotational atherectomy which we felt as an evolving alternative approach to treat the calcified total occlusion.

scholarly journals s Chronic total occlusion in ostium of right coronary artery – retrograde approach as the first-choice method of revascularization?

2013 ◽  
Vol 4 ◽  
pp. 337-340 ◽  
Author(s):  
Leszek Bryniarski ◽  
Tomasz Kameczura ◽  
Sławomir Surowiec ◽  
Bogdan Januś ◽  
Bogusław Derlaga ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Chronic Total Occlusion ◽  
Retrograde Approach ◽  
Total Occlusion ◽  
First Choice ◽  
Choice Method

scholarly journals A novel real-time intravascular ultrasound double-lumen microcatheter for recanalization of chronic total occlusion: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Yanzhuo Ma ◽  
Yuhong Peng ◽  
Gang Wang ◽  
Leisheng Ru
Keyword(s):  
Coronary Artery ◽  
Real Time ◽  
Intravascular Ultrasound ◽  
Right Coronary Artery ◽  
Chronic Total Occlusion ◽  
True Lumen ◽  
Double Lumen ◽  
Total Occlusion ◽  
New Device ◽  
The Right

Abstract Background Chronic total occlusion revascularization remains a challenging problem because of its complexity. We present a case of a patient with chronic total occlusion who was successfully revascularized with the use of a new device called a real-time intravascular ultrasound double-lumen microcatheter. Case presentation A 58-year-old East Asians woman presented to our hospital with a complaint of recurrent chest pain of 5 months’ duration. Angiography revealed chronic total occlusion of the right coronary artery from the right coronary artery ostium to the ostia of the posterolateral and posterior descending branches. A guidewire was passed to the distal right coronary artery but went into the false lumens at the posterior descending and posterolateral ostia after use of the antegrade and retrograde approaches. Hence, we used the new device to pass through the subintimal right coronary artery space with reentry into the true lumen before the posterior descending and posterolateral ostia. A stent was successfully deployed at the posterior descending and posterolateral ostia, and the final result was excellent. Conclusions This device was useful for finding the entry point and for reentry into the true lumen of a chronic total occlusion. It may be a valuable tool for recanalization of complex chronic total occlusion lesions.

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