Snaring the retrograde wire in the aortic root for chronic total occlusion after Bentall operation in a patient with Behcet's disease.

Snaring the retrograde wire in the aortic root was successfully performed for treatment of a chronic total occlusion (CTO) lesion of a saphenous vein graft interposed between a prosthetic graft and the right coronary artery (RCA) ostium in a patient with Behcet's disease after two Bentall operations. Although the coronary guidewire and balloon were able to cross the CTO lesion retrogradely, the coronary guidewire was unable to cross antegradely after ballooning because of intractable engagement of the guiding catheter. A 300 cm guidewire was inserted retrogradely and the guidewire was pulled out of the sheath placed in the right radial artery using a snare. Subsequently, the microcatheter was inserted antegradely into the RCA using the guidewire. The 300 cm guidewire was removed and a standard guidewire was inserted antegradely into the RCA. Finally, a drug-eluting stent was successfully implanted in this difficult-to-treat CTO lesion.