Abstract
A 43 year-old man was admitted due to effort related chest squeezing for 3 months. Coronary angiogram showed a total occlusion of the proximal right coronary artery (RCA) with collateral vessels from left anterior descending artery. The 5F sheathless guiding catheter was engaged into the RCA and the 3F JL3.5 catheter was inserted into left coronary artery via left radial artery for simultaneous contra lateral angiography. We advanced the wire through the lesion with 2 wire technique. Three XIENCE stents (2.5 mm × 28 mm) was inserted from distal to mid RCA, and a 3.0 mm × 15 mm XIENCE stent was inserted to proximal RCA. The final angiographic result showed well expanded stent. The treatment of chronic total occlusion could be possible even slender device by getting hold of the characteristics of the device and evaluating an objective assessment of lesion characteristics.
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Natsuaki M, Morimoto T, Furukawa Y, Nakagawa Y, Kadota K, Iwabuchi M, Shizuta S, Shiomi H, Kimura T. Comparison of 3-year clinical outcomes after transradial versus transfemoral percutaneous coronary intervention. Cardiovasc Interv Ther. 2012;27:84–92.
Kiemeneij F, Laarman GH. Percutaneous transradial artery approach for coronary stent implantation. Cardiovasc Diagn. 1993;30:173–8.
Saito S, Miyake S, Hosokawa G, Tanaka S, Kawamitsu K, Kaneda H, Ikei H, Shiono T. Transradial coronary intervention in Japanese patients. Cathet Cardiovasc Interv. 1999;46:37–41.
Kern MJ, Cohen M, Talley JD, Litvack F, Serota H, Aquirre F, Deligonul U, Bashore TM. Early ambulation after 5 French diagnostic cardiac catheterization: results of a multicenter trial. J Am Coll Cardiol. 1990;15:1475–83.
Metz D, Meyer P, Touati C, Coste P, Petiteau PY, Durand P, Faivre R, Lefevre T, Elaerts J. Comparison of 6F with 7F and 8F guiding catheters for elective coronary angioplasty: results of a prospective, multicenter, randomized trial. Am Heart J. 1997;134:131–7.
Nozue T, Michishita I, Mizuguchi I. Impact of catheter down-sizing and power injector use on the amount of contrast medium delivered. Cardiovasc Interv and Ther. 2010;25:24–8.
Meyer P, Durand P, Melt D, Butto N, Touati C, Gervais A. Six French sheathless coronary angioplasty using a novel technique to introduce the guiding catheter: the INTRUC, a preliminary retrospective study. Cathet Cardiovasc Diagn. 1998;43(3):331–5.
Mamas MA, Fath-Ordoubadi F, Fraser DG. Atraumatic complex transradial intervention using large bore sheathless guide catheter. Catheter Cardiovasc Interv. 2008;72(3):357–64.
Takeshita S, Saito S. Trans coronary intervention using a novel 5-Fr sheathless guiding catheter. Cathet Cardiovasc Interv 2009. Epub ahead of print.
Matsukage T, Yoshimachi F, Masutani M, Saito S, Nakazawa G, Masuda N, Ogata N, Morino Y, Ikari Y. Virtual 3F PCI system for complex percutaneous coronary intervention. Eurointervention. 2009;5:515–7.
Stone GW, Colombo A, Teirstein PS, Moses JW, Leon MB, Reifart NJ, Mintz GS, Hoye A, Cox DA, Baim DS, et al. Percutaneous recanalization of chronically occluded coronary arteries: procedural techniques, devices, and results. Catheter Cardiovasc Interv. 2005;66:217–36.
Surmely JF, Tsuchikane E, Katoh O, Nisida Y, Nakamura M, Nakamura S, Oida A, Hattori E, Suzuki T. New concept for CTO recanalization using controlled antegrade and retrograde subintimal tracking: the CART technique. J Invasive Cardiol. 2006;18:334–8.
Saito S. Different strategies of retrograde approach in coronary angioplasty for chronic total occlusion. Catheter Cardiovasc Interv. 2008;71:8–19.
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.
Saito S, Tanaka S, Hiroe Y, Miyashita Y, Takahasi S, Satake S, Tanaka K. Angioplasty for chronic total occlusion by using tapered-tip guidewires. Catheter Cardiovasc Interv. 2003;59:305–11.
Mitsudo K, Yamashita T, Asakura Y, Muramatsu T, Doi O, Shibata Y, Morino Y. Recanalization strategy for chronic total occlusion with tapered and stiff-tip guidewire. The results of CTO new techniQUE for STandard procedure (CONQUEST) trial. J Invasive Cardiol. 2008;20(11):571–7.
Matsukage T, Masutani M, Yoshimachi F, Takahashi A, Katsuki T, Saito S, Terai H, Katahira Y, Uehara Y, Tohara S, Ohba Y, Shinohara S, Hata T, Ikari Y. A prospective multicenter registry of 0.010-inch guidewire and compatible system for chronic total occlusion: The PIKACHU Registry. Catheter Cardiovasc Interv. 2010;75:1006–12.
Morino Y, Abe M, Morimoto T, Kimura T, Hayashi Y, Muramatsu T, Ochiai M, Noguchi Y, Kato K, Shibata Y, Hiasa Y, Doi O, Yamashita T, Hinohara T, Tanaka H, Mitsudo K. Predicting successful guidewire crossing through chronic total occlusion of native coronary lesions with 30 minutes. J Am Coll Cardiol Intv. 2011;4:213–21.
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Nakamura, R., Ota, K., Miyai, N. et al. A successful treatment for a lesion of chronic total occlusion using a virtual 3 Fr guiding catheter. Cardiovasc Interv and Ther 28, 66–70 (2013). https://doi.org/10.1007/s12928-012-0117-0
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DOI: https://doi.org/10.1007/s12928-012-0117-0