A novel percutaneous coronary intervention technique for chronic total occlusion: Contralateral angiography with a single guiding catheter

Catheter Cardiovasc Interv. 2016 May;87(6):E229-32. doi: 10.1002/ccd.26268. Epub 2015 Nov 3.

Abstract

We report two successful cases with a new percutaneous coronary intervention (PCI) technique to treat chronic total occlusion (CTO) by using contra-lateral coronary angiography with a single guiding catheter (GC) safely. Firstly, a GC was inserted into the coronary artery supplying collaterals and a microcatheter was inserted into the distal side of the coronary artery. Then, the GC was retroflexed and engaged in the targeted coronary artery with CTO. While the contra-lateral coronary artery was visualized by injection through a microcatheter, a guide wire was controlled and passed through the CTO lesion. Two sheaths insertion were necessary to perform contra-lateral angiography in CTO PCI. This new technique makes it possible to perform safe contra-lateral angiography with a single sheath and a single GC. It could reduce vascular access complication rates. © 2015 Wiley Periodicals, Inc.

Keywords: chronic total occlusion; keyhole intervention; slender percutaneous coronary intervention; trans-radial intervention.

Publication types

  • Case Reports

MeSH terms

  • Chronic Disease
  • Collateral Circulation
  • Coronary Angiography / methods*
  • Coronary Circulation / physiology*
  • Coronary Occlusion / diagnosis
  • Coronary Occlusion / surgery*
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / physiopathology
  • Coronary Vessels / surgery*
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / instrumentation*