The retrograde technique for recanalization of chronically occluded coronary arteries: case series report

Stefan Juričić; Milorad Tešić; Milan Dobrić; Srdjan Aleksandrić; Zlatko Mehmedbegović; Goran Stanković; Dejan Orlić; Branko Beleslin; Siniša Stojković

doi:10.2298/VSP200606124J

Stefan Juričić University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
Milorad Tešić University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
Milan Dobrić University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
Srdjan Aleksandrić University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
Zlatko Mehmedbegović University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
Goran Stanković University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
Dejan Orlić University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
Branko Beleslin University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
Siniša Stojković University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP200606124J

Keywords: coronary occlusion, endovascular procedures, methods, percutaneous coronary intervention

Abstract

Introduction. Chronic total occlusion (CTO) of the coronary artery still represents one of the most challenging lesion subsets in the field of interventional cardiology. Considering the complexity and increased risk posed by the retrograde approach, it is most often performed after a failed antegrade approach. Case report. We present a series of cases describing the retrograde approach as a special technique for treating CTO of the coronary artery. All cases had some special characteristics that are part of a dedicated portfolio in every catheterization lab today. In our series of cases, all three percutaneous coronary interventions (PCI) with a different strategies of the retrograde approach and supported with rotational atherectomy or intravascular ultrasound finished with successful recanalization of CTO. Conclusion. In cases where there is the presence of “interventional” collaterals, as well as when the antegrade approach is very difficult, the retrograde approach can increase the success rate of procedures. The retrograde approach requires a long learning curve as well as very skilled and experienced operators who are able to perform the procedure independently.

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