"Rendezvous in coronary" technique with the retrograde approach for chronic total occlusion.
Percutaneous coronary intervention (PCI) was performed for a chronic total occlusion (CTO) of the right coronary artery (RCA) in a 77-year-old male patient. A guidewire could not be passed through the vessel using the antegrade approach, so we tried the retrograde approach via a collateral septal channel. A Fielder FC guidewire (Asahi Intecc Co. Ltd., Aichi, Japan) was passed through the septal channel, and a Corsair catheter (Asahi Intecc) was advanced to the distal side of the CTO in the RCA. However, the guidewire could not be advanced from the false lumen to the true lumen using the kissing-wire technique (KWT) or the reverse controlled antegrade retrograde tracking (CART) technique. Therefore, we retracted the Corsair channel dilator for a #4PD and tried to advance the antegrade Conquest Pro guidewire (Asahi Intecc) from a straight subintimal site into the retrograde channel dilator catheter. After several attempts, the antegrade Conquest guidewire successfully entered the retrograde channel dilator catheter. Subsequently, a Cypher stent (Cordis Corp., Miami Lakes, Florida) was successfully placed. The "rendezvous in coronary" technique was useful for this CTO patient, in whom it was difficult to advance a guidewire into the true lumen by the KWT and CART techniques during the retrograde approach.
Muramatsu
Toshiya
T
Division of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 36-1 Shimosueyoshi, Tsurumi, Yokohama-shi, Kanagawa 230012 Japan. t-mura@tj8.so-net.ne.jp
Tsukahara
Reiko
R
Ito
Yoshiaki
Y
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000379:methods*; D006328:Cardiac Catheterization; D002908:Chronic Disease; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male