Septum hematoma: a complication of retrograde wiring in chronic total occlusion.
In spite of the remarkable technological innovation and improved outcomes with percutaneous coronary intervention (PCI), chronically total occlusion in coronary arteries (CTO) remains a formidable challenge for coronary interventionalist. Recently Japanese interventionists have proposed a retrograde wiring technique which provides another way to resolve such difficulties. The retrograde wire in the distal CTO vessel can then be used as a clear landmark in the distal true lumen, facilitating antegrade wiring and possibly increasing the success rate of CTO-PCI. Reported here is a patient who experienced retrograde wire technique but suffered from a complication with septum hematoma and myocardial infarction. The patient had a complete recovery of chest symptoms and resolution of septum hematoma in 1 month. Retrograde wire manipulation should be used as a last resort and via a large collateral vessel in the treatment of CTO.
Lin
Tsung-Hsien
TH
Wu
Ding-Kwo
DK
Su
Ho-Ming
HM
Chu
Chih-Sheng
CS
Voon
Wen-Chol
WC
Lai
Wen-Ter
WT
Sheu
Sheng-Hsiung
SH
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000628:therapy; D004452:Echocardiography; D005500:Follow-Up Studies; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000293:injuries*; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012075:Remission, Spontaneous; D014057:Tomography, X-Ray Computed