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Advanced CTO Techniques: Retrograde Case Review IX

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Presentation on theme: "Advanced CTO Techniques: Retrograde Case Review IX"— Presentation transcript:

1 Advanced CTO Techniques: Retrograde Case Review IX
Shigeru SAITO, MD, FACC Kamakura & Sapporo, JAPAN

2 Shigeru Saito, MD I have no real or apparent conflicts of interest to report.

3 Why retrograde approach is necessary?
If we can pass a guidewire through the collateral channels, we can definitely ensure the true lumen distal to the CTO. By applying the bi-lateral approach, We can ensure the strongest back-up and/or traction force. We can straighten any severely tortuous arteries.

4 Why retrograde approach is necessary?
The live case transmitted from Busan National University Yangsan Hospital on April 29 during ANGIOPLASTY SUMMIT-TCTAP 2010 in Seoul, Korea

5 Why retrograde approach is necessary?
The live case transmitted from Busan National University Yangsan Hospital on April 29 during ANGIOPLASTY SUMMIT-TCTAP 2010 in Seoul, Korea

6 Why retrograde approach is necessary?
The live case transmitted from Busan National University Yangsan Hospital on April 29 during ANGIOPLASTY SUMMIT-TCTAP 2010 in Seoul, Korea

7 Why retrograde approach is necessary?
The live case transmitted from Busan National University Yangsan Hospital on April 29 during ANGIOPLASTY SUMMIT-TCTAP 2010 in Seoul, Korea

8 Why retrograde approach is necessary?
The live case transmitted from Busan National University Yangsan Hospital on April 29 during ANGIOPLASTY SUMMIT-TCTAP 2010 in Seoul, Korea

9 Why retrograde approach is necessary?
The live case transmitted from Busan National University Yangsan Hospital on April 29 during ANGIOPLASTY SUMMIT-TCTAP 2010 in Seoul, Korea

10 Why retrograde approach is necessary?
The live case transmitted from Busan National University Yangsan Hospital on April 29 during ANGIOPLASTY SUMMIT-TCTAP 2010 in Seoul, Korea

11 Why retrograde approach is necessary?
The live case transmitted from Busan National University Yangsan Hospital on April 29 during ANGIOPLASTY SUMMIT-TCTAP 2010 in Seoul, Korea

12 A case with CTO of anomalous-origin RCA

13 A case with CTO of anomalous-origin RCA

14 A case with CTO of anomalous-origin RCA

15 A case with CTO of anomalous-origin RCA

16 A case with CTO of anomalous-origin RCA

17 A case with CTO of anomalous-origin RCA

18 A case with CTO of anomalous-origin RCA

19 A case with CTO of anomalous-origin RCA

20 A case with CTO of anomalous-origin RCA

21 A case with CTO of anomalous-origin RCA

22 A case with CTO of anomalous-origin RCA

23 A case with CTO of anomalous-origin RCA

24 Retrograde Approach for Chronic Total Occlusions
Taketani Y, Kaneda H, Saito S. Successful coronary intervention for chronic total occlusion using a retrograde approach with biradial arteries. Invasive Cardiol. 2007; 19: E281-4. Kaneda H, Takahashi S, Saito S. Successful coronary intervention for chronic total occlusion in an anomalous right coronary artery using the retrograde approach via a collateral vessel. Invasive Cardiol. 2007; 19: E1-4. Saito S. Different strategies of retrograde approach for CTO lesions. Cathet Cardiovasc Interv 2008; 71: 8-19. Matsumi J, Saito S. Progress in the retrograde approach for chronic total coronary artery occlusion: a case with successful angioplasty using CART and reverse-anchoring techniques 3 years after failed PCI via a retrograde approach. Catheter Cardiovasc Interv. 2008; 71: Matsumi J, Adachi K, Saito S. A unique complication of the retrograde approach in angioplasty for chronic total occlusion of the coronary artery.Catheter Cardiovasc Interv. 2008; 72:

25 Summary For the case with a CTO lesion in the proximal RCA with anomalous origin, I performed the bi-directional approach. By the use of the guidewire externalization, I could achieve the strong backup support. According to the situation, we have to change our strategies flexibly.


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