Retrograde Intervention of a Right Coronary Artery Chronic Total Occlusion Through an Ipsilateral Kugel's Artery...

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Vascular Biology

Background:

• Chronic total occlusion (CTO) of the right coronary artery presents significant challenges in revascularization.
• The arteria anastomotica auricularis magna, also known as Kugel's artery, serves as a potential collateral pathway.
• Percutaneous coronary intervention (PCI) for complex CTOs requires advanced techniques.

Observation:

• A unique case of right coronary artery CTO was identified.
• The ipsilateral Kugel's artery was utilized as a collateral channel for intervention.
• Anatomical variations in coronary collaterals can influence interventional strategies.

Findings:

• Successful recanalization of the right coronary artery CTO was achieved.
• The reverse controlled antegrade and retrograde subintimal tracking (CRT) technique was employed.
• CRT facilitated retrograde crossing and antegrade recanalization via the Kugel's artery collateral.

Implications:

• This case demonstrates the feasibility of using Kugel's artery collaterals for CTO intervention.
• The CRT technique offers a viable option for complex coronary CTOs.
• Further research may explore the broader application of this technique in similar cases.