Successful recanalization of a chronic occluded left anterior descending coronary artery with a modification of the retrograde proximal true lumen puncture technique: the antegrade microcatheter probing technique.

Chronic total occlusions (CTO) still remain one of the most technically challenging fields in interventional cardiology. Here we report a case of successful retrograde recanalization of an occluded proximal left anterior descending coronary artery with a modification of the "retrograde proximal true lumen puncture" technique. By combining this strategy with a novel antegrade guide wire access through a microcatheter which was placed into the antegrade guiding catheter with the "reverse anchoring balloon" technique (the "antegrade microcatheter probing" technique), the need for retrograde CTO lesion dilatations has been eliminated, making the procedure easier and faster. This modified retrograde approach might provide a feasible and safe technique for antegrade guide wire access during retrograde CTO recanalization. (c) 2009 Wiley-Liss, Inc.