A novel percutaneous coronary intervention technique for chronic total occlusion: Contralateral angiography with a single guiding catheter.

We report two successful cases with a new percutaneous coronary intervention (PCI) technique to treat chronic total occlusion (CTO) by using contra-lateral coronary angiography with a single guiding catheter (GC) safely. Firstly, a GC was inserted into the coronary artery supplying collaterals and a microcatheter was inserted into the distal side of the coronary artery. Then, the GC was retroflexed and engaged in the targeted coronary artery with CTO. While the contra-lateral coronary artery was visualized by injection through a microcatheter, a guide wire was controlled and passed through the CTO lesion. Two sheaths insertion were necessary to perform contra-lateral angiography in CTO PCI. This new technique makes it possible to perform safe contra-lateral angiography with a single sheath and a single GC. It could reduce vascular access complication rates.