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Updated: Dec 23, 2025

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Retrograde Approach to Chronic Total Occlusion Percutaneous Coronary Intervention
Michael Megaly1,2, Iosif Xenogiannis1, Nidal Abi Rafeh3
1Minneapolis Heart Institute, Abbott Northwestern Hospital, MN (M.M., I.X., M.N.B., E.S.B.).
Abstract:
The retrograde approach has increased the success rate of chronic total occlusion percutaneous coronary intervention but has also been associated with a higher risk of complications. The retrograde approach is usually performed in complex lesions, in which the antegrade approach is not feasible or has failed previously. Using a systematic 10-step approach can maximize the likelihood of success and minimize the risks of retrograde chronic total occlusion interventions.
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