First reported revascularization of complex occlusion of the right coronary artery using the IVUS-guided reverse CART technique via a gastroepiploic artery graft
When patients who have previously undergone coronary artery bypass graft surgery develop ischemia symptoms that cannot be controlled by optimal medical therapy, repeat revascularization is indicated. The revascularization strategy should be based on individual clinical and anatomical characteristics...
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| Veröffentlicht in: | Heart and vessels 2016-02, Vol.31 (2), p.251-255 |
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| creator | Dai, Jian Katoh, Osamu Zhou, Hua Kyo, Eisho |
| description | When patients who have previously undergone coronary artery bypass graft surgery develop ischemia symptoms that cannot be controlled by optimal medical therapy, repeat revascularization is indicated. The revascularization strategy should be based on individual clinical and anatomical characteristics. We report here a challenging patient who presented with recurrent stable angina due to worsening of a proximal right coronary artery (RCA) stenosis to chronic total occlusion (CTO) after anastomosis of the right gastroepiploic artery (GEA) to the posterior descending artery. A soft guidewire was advanced through the right GEA collateral channel to the distal end of the CTO, but the dedicated CTO guidewires could not be advanced across the severely calcified CTO using the retrograde wire crossing or kissing wire techniques. The RCA was eventually revascularized by implantation of drug-eluting stents using the intravascular ultrasound-guided reverse controlled antegrade and retrograde subintimal tracking technique. |
| doi_str_mv | 10.1007/s00380-014-0568-6 |
| format | Article |
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The revascularization strategy should be based on individual clinical and anatomical characteristics. We report here a challenging patient who presented with recurrent stable angina due to worsening of a proximal right coronary artery (RCA) stenosis to chronic total occlusion (CTO) after anastomosis of the right gastroepiploic artery (GEA) to the posterior descending artery. A soft guidewire was advanced through the right GEA collateral channel to the distal end of the CTO, but the dedicated CTO guidewires could not be advanced across the severely calcified CTO using the retrograde wire crossing or kissing wire techniques. 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The revascularization strategy should be based on individual clinical and anatomical characteristics. We report here a challenging patient who presented with recurrent stable angina due to worsening of a proximal right coronary artery (RCA) stenosis to chronic total occlusion (CTO) after anastomosis of the right gastroepiploic artery (GEA) to the posterior descending artery. A soft guidewire was advanced through the right GEA collateral channel to the distal end of the CTO, but the dedicated CTO guidewires could not be advanced across the severely calcified CTO using the retrograde wire crossing or kissing wire techniques. 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The revascularization strategy should be based on individual clinical and anatomical characteristics. We report here a challenging patient who presented with recurrent stable angina due to worsening of a proximal right coronary artery (RCA) stenosis to chronic total occlusion (CTO) after anastomosis of the right gastroepiploic artery (GEA) to the posterior descending artery. A soft guidewire was advanced through the right GEA collateral channel to the distal end of the CTO, but the dedicated CTO guidewires could not be advanced across the severely calcified CTO using the retrograde wire crossing or kissing wire techniques. The RCA was eventually revascularized by implantation of drug-eluting stents using the intravascular ultrasound-guided reverse controlled antegrade and retrograde subintimal tracking technique.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>25148795</pmid><doi>10.1007/s00380-014-0568-6</doi><tpages>5</tpages></addata></record> |
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| ispartof | Heart and vessels, 2016-02, Vol.31 (2), p.251-255 |
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| subjects | Angioplasty, Balloon, Coronary - instrumentation Biomedical Engineering and Bioengineering Cardiac Catheterization Cardiac Surgery Cardiology Cardiovascular disease Case Report Coronary Angiography - methods Coronary Artery Bypass - adverse effects Coronary Artery Bypass - methods Coronary Occlusion - diagnostic imaging Coronary Occlusion - etiology Coronary Occlusion - therapy Coronary Stenosis - diagnosis Coronary Stenosis - surgery Disease Progression Drug-Eluting Stents Gastroepiploic Artery - transplantation Heart surgery Humans Male Medicine Medicine & Public Health Middle Aged Surgical outcomes Surgical techniques Tomography, X-Ray Computed Treatment Outcome Ultrasonography, Interventional Vascular Surgery |
| title | First reported revascularization of complex occlusion of the right coronary artery using the IVUS-guided reverse CART technique via a gastroepiploic artery graft |
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