A step-by-step guide to mastering retrograde coronary chronic total occlusion intervention in 2018: The author's...

Area of Science:

• Interventional Cardiology
• Vascular Medicine

Background:

• Chronic total occlusion (CTO) represents a significant challenge in percutaneous coronary intervention (PCI).
• CTO lesions are often considered the "last frontier" in PCI due to their complexity.
• The antegrade approach alone has limitations in treating complex CTOs.

Purpose of the Study:

• To provide a comprehensive step-by-step guide for the retrograde approach in CTO PCI.
• To offer alternative techniques for various steps within the retrograde strategy.
• To facilitate the adoption of retrograde recanalization by interventional cardiologists.

Main Methods:

• Detailed description of the retrograde recanalization technique for CTO.
• Inclusion of alternative procedural steps and troubleshooting strategies.
• Emphasis on advancements that enhance safety and efficiency.

Main Results:

• Retrograde recanalization demonstrates high success rates, even in complex CTO cases.
• The technique has evolved, becoming safer, faster, and more successful.
• It serves as a crucial complement to the antegrade approach.

Conclusions:

• The retrograde approach is a vital and effective strategy for CTO PCI.
• This guide aims to empower operators to confidently utilize retrograde recanalization.
• Continued refinement of the technique promises further improvements in patient care for CTO.