Premium
Stumpless chronic total occlusion with no retrograde option
Author(s) -
Dautov Rustem,
Abdul Jawad Altisent Omar,
Rinfret Stéphane
Publication year - 2015
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.25938
Subject(s) - medicine , circumflex , occlusion , radiology , cardiac catheterization , coronary angiography , interventional cardiology , surgery , cardiology , myocardial infarction , artery
When dealing with flush ostial chronic total occlusion (CTO) and no viable retrograde option, the only way to perform recanalization is through an antegrade approach. Such a procedure can be extremely difficult considering the ambiguity of the proximal cap. We demonstrate how we solved ambiguity of the proximal cap of an ostial obtuse marginal CTO with the help of cardiac multidetector computed tomography (MDCT). We also discuss several techniques including bilateral radial approach with home‐made sheathless large‐bore catheters, IVUS‐guided cap puncture, ping‐pong guide catheters engagement in the left main, and bioresorbable vascular scaffold (BVS) for an ostial left circumflex disease that we all used in our CTO case. © 2015 Wiley Periodicals, Inc.