Retrograde Recanalization of Chronic Coronary Occlusions

Furkalo SN*

Received: July 10, 2018;;   Published: July 26, 2018

DOI: 10.32474/ACR.2018.01.000111

Full Text PDF

To view the Full Article   Peer-reviewed Article PDF

Abstract

Chronic coronary occlusion (CTO) is fixed at 1 in 5 patients who underwent cardiac catheterization. Recanalization of chronic coronary occlusions is one of the most difficult for the technical performance of interventional procedures. Successful recanalization CTO associated with better survival compared to patients where the procedure of recanalization of occlusion was not successful. Thus, potential candidates for retrograde recanalization of chronic occlusions of coronary arteries may be: patients after a failed attempt of recanalization with clear indications and motivated to implement PCI; refractory angina with CTO of native coronary arteries after CABG; single-vessel coronary artery disease - RCA or the LAD with preserved left ventricular function and preserved kidney; patients with multivessel disease and related comorbidity, which does not allow to perform coronary artery bypass surgery. From 2007 to the present time we have carried out 125 of retrograde recanalization of chronic occlusions of coronary arteries with a total efficiency of 66.4%. Our data suggest that CTO intervention most often used in LAD - 50% of the RCA - 41.7%, and LCx - in 8.3% of cases. It was succesfull method in CTO cases of RCA - in 86.6% of cases, LAD - in 66% of patients and occlusion and in case of Cx CTO recanalization was succesfull in only 2 patients. Septal collaterals with retrograde approach used in most cases- 101 patients, epicardial collaterals - in 19 cases, and in 4 cases of retrograde access served venous bypass and one mammary coronary bypass – to the LAD.

Keywords: Ischemic heart disease; Chronic coronary occlusion; Coronary stenting; Collateral circulation; Retrograde recanalization of coronary occlusions

Abstract| Introduction| Potential Candidates for a Retrograde Approach| Types and Classification of the Retrograde Approach| Collateral Channels| The Main Materials for the Recanalization of SRT| The Use of Intravascular Ultrasound (IVUS)| Retrograde Wire Externalization| Discussion| References|