OBJECTIVES: To investigate the feasibility and safety of the percutaneous dilatation of coronary septal collaterals and to allow its use as an access for retrograde approach to percutaneous coronary intervention (PCI) of coronary chronic total occlusions (CTOs). BACKGROUND: Despite improvements in percutaneous techniques and materials, CTO recanalization success rate is still suboptimal. The retrograde approach allows to significantly increase this success rate. However, its application via a bypass graft or epicardial collateral can potentially result in severe complications. A safer retrograde access is desired and would allow broadening the application of the retrograde approach in the percutaneous treatment of CTOs. METHODS: After a failed antegrade CTO recanalization attempt, a retrograde approach via septal collaterals was tried in 21 patients (19 males, 2 females). The septal collateral was accessed via the contralateral patent coronary artery and was crossed with a hydrophilic floppy wire. After successful wire crossing of the septal collateral, sequential low pressure dilatation was performed with a 1.25 or 1.5 mm balloon to allow the delivery of a balloon catheter up to the distal CTO site. RESULTS: Successful wire crossing and balloon dilatation of septal collaterals was achieved in 19 cases and in 17 cases, respectively. Postdilatation septal collateral diameter increased significantly reaching a mean diameter of 1.46 +/- 0.38 mm. Retrograde CTO recanalization was successfully performed in 71% of the cases. No major complications occurred. CONCLUSIONS: Coronary septal collaterals can be used as an access for the retrograde approach in the percutaneous treatment of CTOs. (c) 2006 Wiley-Liss, Inc.
OBJECTIVES: To investigate the feasibility and safety of the percutaneous dilatation of coronary septal collaterals and to allow its use as an access for retrograde approach to percutaneous coronary intervention (PCI) of coronary chronic total occlusions (CTOs). BACKGROUND: Despite improvements in percutaneous techniques and materials, CTO recanalization success rate is still suboptimal. The retrograde approach allows to significantly increase this success rate. However, its application via a bypass graft or epicardial collateral can potentially result in severe complications. A safer retrograde access is desired and would allow broadening the application of the retrograde approach in the percutaneous treatment of CTOs. METHODS: After a failed antegrade CTO recanalization attempt, a retrograde approach via septal collaterals was tried in 21 patients (19 males, 2 females). The septal collateral was accessed via the contralateral patent coronary artery and was crossed with a hydrophilic floppy wire. After successful wire crossing of the septal collateral, sequential low pressure dilatation was performed with a 1.25 or 1.5 mm balloon to allow the delivery of a balloon catheter up to the distal CTO site. RESULTS: Successful wire crossing and balloon dilatation of septal collaterals was achieved in 19 cases and in 17 cases, respectively. Postdilatation septal collateral diameter increased significantly reaching a mean diameter of 1.46 +/- 0.38 mm. Retrograde CTO recanalization was successfully performed in 71% of the cases. No major complications occurred. CONCLUSIONS: Coronary septal collaterals can be used as an access for the retrograde approach in the percutaneous treatment of CTOs. (c) 2006 Wiley-Liss, Inc.
Authors: Dimitri Karmpaliotis; Aris Karatasakis; Khaldoon Alaswad; Farouc A Jaffer; Robert W Yeh; R Michael Wyman; William L Lombardi; J Aaron Grantham; David E Kandzari; Nicholas J Lembo; Anthony Doing; Mitul Patel; John N Bahadorani; Jeffrey W Moses; Ajay J Kirtane; Manish Parikh; Ziad A Ali; Sanjog Kalra; Phuong-Khanh J Nguyen-Trong; Barbara A Danek; Judit Karacsonyi; Bavana V Rangan; Michele K Roesle; Craig A Thompson; Subhash Banerjee; Emmanouil S Brilakis Journal: Circ Cardiovasc Interv Date: 2016-06 Impact factor: 6.546
Authors: Suk Hwan Chung; Moo Hyun Kim; Long Hao Yu; Jong Sung Park; Kyung Ho Kim; Dong Sung Kum; Tae Ho Park; Kwang Soo Cha; Young Dae Kim Journal: Korean Circ J Date: 2009-06-30 Impact factor: 3.243