ANTEGRADE/RETROGRADE LEFT MAIN ARTERY STENTING Ricardo Vicuna, MD Paul Silverman, MD Bruce Abramowitz, MD University of Illinois Chicago/Advocate Christ.

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Presentation transcript:

ANTEGRADE/RETROGRADE LEFT MAIN ARTERY STENTING Ricardo Vicuna, MD Paul Silverman, MD Bruce Abramowitz, MD University of Illinois Chicago/Advocate Christ Medical Center

55 year old man with worsening angina despite maximal medical therapy PMHxHTN, hyperlipidemia Emergent CABG 4 months prior to current admission Grafts LIMA-LAD SVG-PDA SVG-Diagonal Ricardo Vicuna,University of Illinois Chicago/Advocate Christ Med Ctr Antegrade/Retrograde LM stenting : History SCAI C3 Summit Chicago May 12-13, 2006

Antegrade/Retrograde LM stenting: Case Presentation Ricardo Vicuna,University of Illinois Chicago/Advocate Christ Med Ctr No LM ostium

SCAI C3 Summit Chicago May 12-13, 2006 Antegrade/Retrograde LM stenting: Case Presentation Ricardo Vicuna,University of Illinois Chicago/Advocate Christ Med Ctr Retrograde wire into LM and Ao

SCAI C3 Summit Chicago May 12-13, 2006 Antegrade/Retrograde LM stenting: Case Presentation Ricardo Vicuna,University of Illinois Chicago/Advocate Christ Med Ctr

SCAI C3 Summit Chicago May 12-13, 2006 Antegrade/Retrograde LM stenting: Case Presentation Ricardo Vicuna,University of Illinois Chicago/Advocate Christ Med Ctr Antegrade/Retrograde Wires into LM

SCAI C3 Summit Chicago May 12-13, 2006 Antegrade/Retrograde LM stenting: Case Presentation Ricardo Vicuna,University of Illinois Chicago/Advocate Christ Med Ctr Final Result

Retrograde determination of the origin of LM CTO can be achieved with a guidewire if the standard antegrade approach proves to be unsuccessful Antegrade recanalization of the LM CTO can then be attempted after confirmation of the intraluminal location of the two guidewires Ricardo Vicuna,University of Illinois Chicago/Advocate Christ Med Ctr Antegrade/Retrograde LM stenting: Take Home Points SCAI C3 Summit Chicago May 12-13, 2006