Dataset Information

Exit of CrossBoss between stent struts within chronic total occlusion to subintimal space: Completion of case via retrograde approach with rendezvous in coronary.

ABSTRACT: We present a case of successful percutaneous revascularization of a chronic total coronary occlusion due to in-stent restenosis. The CrossBoss catheter (BridgePoint Medical, Minneapolis, MN, USA) was used initially because it is reported to be effective in this setting with a low risk of exiting occluded stents. To the best of our knowledge, this is the first reported case of a CrossBoss penetrating through stent struts into the subintimal space. The case was completed via the retrograde approach with 'rendezvous in coronary'. <Learning objective: Recognize the potential of the CrossBoss catheter to exit between stent struts within chronic total occlusions. Appreciate the need to check the position of the CrossBoss catheter with respect to stents within a chronic total occlusion. Identify the potential for 'rendezvous in coronary' within the subintimal space with the CrossBoss catheter and a retrograde guidewire.>.

SUBMITTER: Ntatsios A

PROVIDER: S-EPMC6277932 | biostudies-literature | 2014 May

REPOSITORIES: biostudies-literature

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Exit of CrossBoss between stent struts within chronic total occlusion to subintimal space: Completion of case via retrograde approach with rendezvous in coronary.

Ntatsios Antonios A Smith William Howard Thornton WHT

Journal of cardiology cases 20140206 5

We present a case of successful percutaneous revascularization of a chronic total coronary occlusion due to in-stent restenosis. The CrossBoss catheter (BridgePoint Medical, Minneapolis, MN, USA) was used initially because it is reported to be effective in this setting with a low risk of exiting occluded stents. To the best of our knowledge, this is the first reported case of a CrossBoss penetrating through stent struts into the subintimal space. The case was completed via the retrograde approac ...[more]

PMID: 30534320

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Project description:BackgroundIn recent years, the retrograde approach has become a common practice in the treatment of chronic total occlusion (CTO) of coronary ostium which is arising abnormally and has an ambiguous proximal cap. In this case report, we report a case of retrograde percutaneous coronary intervention (PCI) done successfully on an abnormally originating artery which was guideliner assisted. Case Presentation. A 65-year-old gentleman with a history of hypertension, diabetes, and PCI presented to us with angina. Physical examination, electrocardiography (ECG), and echocardiography were done. Coronary angiography (CAG) revealed a normal left anterior descending artery (LAD), an anomalous circumflex (CX) artery arising from the right cusp. The abnormal CX had an implanted stent from which the abnormal right coronary artery (RCA) was arising and had a CTO. It also revealed the retrograde filling of distal RCA through grade 2 Werner collateral channels (CCs) from the LAD, a long CTO segment with a distal cap at the bifurcation. PCI of an RCA-CTO was scheduled utilizing a primary retrograde strategy, since antegrade ostium was abnormal in origin, and the patient was previously stented across the origin. The retrograde wire was externalized, and the procedure was completed with 3 overlapping drug-eluting stents (DESs). We used a guideliner which also assisted in the capture of retrograde corsair during the retrograde procedure of CTO [assisted reverse controlled antegrade and retrograde tracking (CART)]. These measures helped us to complete the CTO intervention successfully.ConclusionThe antegrade crossing is the most common approach to CTOs. However, it is sometimes difficult to penetrate the proximal hard ambiguous cap with guidewires, especially in the case of CTOs of anomalous coronary arteries because of a lack of support. Herein, we describe an iteration of reverse CART technique using a guide extensor catheter to facilitate externalizing the retrograde wire from false to true lumen.

Dataset Information

Exit of CrossBoss between stent struts within chronic total occlusion to subintimal space: Completion of case via retrograde approach with rendezvous in coronary.

Publications

Exit of CrossBoss between stent struts within chronic total occlusion to subintimal space: Completion of case via retrograde approach with rendezvous in coronary.

Similar Datasets

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