Makoto Sekiguchi

Retrograde percutaneous recanalization of chronic total occlusion of the left anterior descending artery through an extremely tortuous right ventricular branch

We report a case of chronic total occlusion (CTO) of the left anterior descending artery, which was treated by percutaneous coronary intervention using a retrograde approach via an extremely tortuous right ventricular branch of the right coronary artery. New concept guidewires and a channel dilator were advanced by delicate manipulation into the distal site of the CTO and a successful percutaneous recanalization was performed. These new concept guidewires may facilitate the retrograde approach for CTOs via tortuous collateral channels.

A Novel Wiring Technique to Insert a Retrograde Guidewire Directly Into the Antegrade Guiding Catheter at the Ascending Aorta for Retrograde Percutaneous Recanalization of an Ostial Coronary Total Occlusion.

In recent years, the use of a retrograde approach has become a common practice in the treatment of chronic total occlusion (CTO) of the coronary ostium and artery with an anomalous origin. Use of this approach has increased the chances of a successful percutaneous coronary intervention (PCI). However, the approach requires capturing the retrograde guidewire within the aorta, which can often pose a problem. Therefore, we developed a technique in which the retrograde guidewire is passed through the CTO and inserted directly into the antegrade guiding catheter in the ascending aorta. This technique enabled the successful treatment of the ostial CTO of the right coronary artery using retrograde PCI.