A Case Report on Percutaneous Coronary Intervention in Chronic Total Occlusion by Retrograde Visualization

Area of Science:

• Interventional Cardiology
• Vascular Surgery
• Cardiovascular Imaging

Background:

• Chronic total occlusions (CTO) present significant challenges in percutaneous coronary intervention.
• Retrograde flow visualization is crucial for successful antegrade recanalization strategies.
• Bilateral arterial access techniques are emerging for complex CTO interventions.

Observation:

• A case of CTO in the left anterior descending (LAD) artery is presented.
• Bilateral femoral artery access was employed for simultaneous contrast injection.
• Retrograde flow in the LAD was visualized via contralateral artery cannulation.

Findings:

• The bilateral femoral access facilitated detailed visualization of retrograde flow.
• Simultaneous contrast injections provided anatomical roadmap for antegrade wire progression.
• Successful antegrade recanalization of the CTO was achieved using this approach.

Implications:

• Bilateral arterial access, particularly using femoral arteries, offers a valuable strategy for CTO interventions.
• Enhanced visualization through contralateral injections improves procedural success rates.
• This approach may become increasingly reported for complex coronary interventions.