Recanalization of chronic total occlusions (CTOs) via grafts has been described previously. However, the insertion of the graft into the distal vessel is often characterized by an unfavorable entry angle which renders an antegrade approach challenging. In the present case, we describe how retrograde recanalization of the proximal right coronary artery (RCA) via a right internal mammary artery graft facilitated antegrade revascularization of the CTO of the RCA.
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