Abstract
The retrograde approach, a new technique of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO), allows coronary interventionalists to improve the success rate. However, this technique occasionally has serious complications. We report a case with the occlusion of left main coronary artery (LMCA) during PCI for CTO in the proximal LCX with retrograde approach because of backward spiral dissection formed by retrograde wire. We could perform bail-out stenting for LMCA. In PCI for CTO in the proximal site of left coronary artery with retrograde approach, we should keep in mind a backward dissection to LMCA formed by retrograde wire.
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Suero JA, Marso AP, Jones PG, Laster SB, Huber KC, Giorgi LV, et al. Procedural outcomes and long-term survival among patients undergoing percutaneous coronary intervention of a chronic total occlusion in native coronary arteries: a 20-year experience. J Am Coll Cardiol. 2001;38:409–14.
Hoye A, van Domburg RT, Sonnenschein K, Serruys PW. Percutaneous coronary intervention for chronic total occlusions: the Thoraxcenter experience 1992–2002. Eur Heart J. 2005;26:2630–6.
Olivari Z, Rubartelli P, Piscione F, Ettori F, Fontanelli A, Salemme L, et al. TOAST-GISE Investigators. Immediate results and one-year clinical outcome after percutaneous coronary interventions in chronic total occlusions: data from a multicenter, prospective, observational study (TOAST-GISE). J Am Coll Cardiol. 2003;41:1672–8.
Muramatsu T, Hirano K, Tsukahara R, Ito Y, Ishimori H, Nakano M, Sasao K, et al. Long-term outcome of percutaneous transluminal coronary intervention for chronic total occlusion in the BMS era in Japanese. Cardiovasc Interv Ther. 2010;25:78–84.
Surmely JF, Tsuchikane E, Katoh O, Nishida Y, Nakayama M, Nakamura S, et al. New concept for CTO recanalization using controlled antegrade and retrograde subintimal tracking: the CART technique. J Invasive Cardiol. 2006;18:334–8.
Surmely JF, Katoh O, Tsuchikane E, Nasu K, Suzuki T. Coronary septal collaterals as an access for the retrograde approach in the percutaneous treatment of coronary chronic total occlusions. Catheter Cardiovasc Interv. 2007;69:826–32.
Tsujita K, Maehara A, Mintz GS, Kubo T, Doi H, Lansky AJ, et al. Intravascular ultrasound comparison of the retrograde versus antegrade approach to percutaneous intervention for chronic total coronary occlusions. J Am Coll Cardiol Intv. 2009;2:846–54.
Sumitsuji S, Inoue K, Ochiai M, Tsuchikane E, Ikeno F. Fundamental wire technique and current standard strategy of percutaneous intervention for chronic total occlusion with histopathological insights. J Am Coll Cardiol Intv. 2011;4:941–51.
Muramatsu T, Tsukahara R, Ito Y. A novel intravascular ultrasound-guided percutaneous coronary angioplasty technique via the retrograde approach for chronic total occlusion. Cardiovasc Interv Ther. 2011;26:45–51.
Rathore S, Katoh O, Matsuo H, Terashima M, Tanaka N, Kinoshita Y, et al. Retrograde percutaneous recanalization of chronic total occlusion of the coronary arteries: procedural outcomes and predictors of success in contemporary practice. Circ Cardiovasc Interv. 2009;2:124–32.
Kimura M, Katoh O, Tsuchikane E, Nasu K, Kinoshita Y, Ehara M, et al. The efficacy of a bilateral approach for treating lesions with chronic total occlusions: the CART (Controlled antegrade and retrograde subintimal tracking) registry. J Am Coll Cardiol Intv. 2009;11:1135–41.
Hoye A, Tanabe K, Lemos PA, Aoki J, Saia F, Arampattzis C, et al. Significant reduction in restenosis after the use of sirolimus-eluting stents in the treatment of chronic total occlusions. J Am Coll Cardiol. 2004;43:1954–8.
Werner GS, Krack A, Schwarz G, Prochnau D, Betge S, Figulla HR. Prevention of lesion recurrence in chronic total occlusions by paclitaxel-eluting stents. J Am Coll Cardiol. 2004;44:2301–6.
Ge L, Iakovou I, Cosgrave J, Chieffo A, Montorfano M, Michev I, et al. Immediate and mid-term outcomes of sirolimus-eluting stent implantation for chronic total occlusions. Eur Heart J. 2005;26:1049–51.
Prasad A, Rihal CS, Lennon RJ, Wiste HJ, Singh M, Holmes DR Jr. Trends in outcomes after percutaneous coronary intervention for chronic total occlusions: a 25-year experience from the mayo clinic. J Am Coll Cardiol. 2007;49:1611–8.
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Ino, Y., Toyoda, Y., Ishii, S. et al. Occlusion of left main coronary artery during percutaneous coronary intervention for chronic total occlusion of left circumflex artery with retrograde approach. Cardiovasc Interv and Ther 28, 81–86 (2013). https://doi.org/10.1007/s12928-012-0116-1
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DOI: https://doi.org/10.1007/s12928-012-0116-1