CT-Guided CTO-PCI Overcoming Bypass Surgery-Induced Native Coronary Artery Tenting

Area of Science:

• Interventional Cardiology
• Cardiovascular Imaging
• Vascular Surgery

Background:

• Percutaneous coronary intervention in calcified lesions presents challenges.
• Accurate vessel navigation is crucial for procedural success.

Purpose of the Study:

• To describe a case of successful antegrade wire crossing in a calcified left anterior descending artery.
• To highlight the utility of computed tomography in confirming wire position during complex interventions.

Main Methods:

• Antegrade wire crossing of a calcified left anterior descending artery.
• Intraprocedural angiography.
• Reanalysis of computed tomography images.

Main Results:

• Successful antegrade wire crossing was achieved.
• Angiography suggested an aberrant wire course.
• Computed tomography reanalysis confirmed the wire was correctly positioned within the left internal mammary artery to LAD anastomosis.

Conclusions:

• Computed tomography is valuable for clarifying wire position in challenging coronary interventions.
• This case demonstrates successful management of an unexpected wire course during PCI.