Cardiovascular Intervention and Therapeutics

, Volume 28, Issue 1, pp 91–97 | Cite as

Percutaneous coronary intervention by retrograde approach for chronic total occlusion of the proximal left anterior descending artery via a gastroepiploic artery graft

  • Yoshiaki Mibiki
  • Hisashi Kikuta
  • Takenori Sumiyoshi
  • Muneichi Shibata
  • Noboru Osawa
Case Report


Coronary arteries connecting to septal branch are often occluded in post-coronary artery bypass graft cases. A 70-year-old male had undergone CABG; radial artery graft to the LCX, and gastroepiploic artery (GEA) graft to the RCA. Coronary angiography revealed total occlusion in proximal LAD, while both graft vessels had good flow. Retrograde percutaneous coronary intervention (PCI) procedure from the septal channel via GEA graft to the RCA was performed for total occlusion of LAD. Despite the tortuous GEA, deep engagement with a 4-french guiding catheter ensured powerful back-up force. After retrograde wire crossing, two drug-eluting stents were implanted, successfully.


Retrograde procedure Chronic total occluded lesions Gastroepiploic artery 


Conflict of interest

Authors have no financial disclosure of conflict of interest to declare.


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Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2012

Authors and Affiliations

  • Yoshiaki Mibiki
    • 1
  • Hisashi Kikuta
    • 1
  • Takenori Sumiyoshi
    • 1
  • Muneichi Shibata
    • 1
  • Noboru Osawa
    • 1
  1. 1.Division of CardiologyMiyagi Prefectural Cardiovascular and Respiratory CenterKuriharaJapan

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