title: Stumpless chronic total occlusion with no retrograde option: Multidetector computed tomography-guided intervention via bi-radial approach utilizing bioresorbable vascular scaffold.
abstract: When dealing with flush ostial chronic total occlusion (CTO) and no viable retrograde option, the only way to perform recanalization is through an antegrade approach. Such a procedure can be extremely difficult considering the ambiguity of the proximal cap. We demonstrate how we solved ambiguity of the proximal cap of an ostial obtuse marginal CTO with the help of cardiac multidetector computed tomography (MDCT). We also discuss several techniques including bilateral radial approach with home-made sheathless large-bore catheters, IVUS-guided cap puncture, ping-pong guide catheters engagement in the left main, and bioresorbable vascular scaffold (BVS) for an ostial left circumflex disease that we all used in our CTO case.
authors.affiliation: Institut Universitaire De Cardiologie Et De Pneumologie De Québec (Quebec Heart and Lung Institute), Laval University, Quebec, Canada.
authors.forename: Rustem
authors.initials: R
authors.lastname: Dautov
authors.affiliation: Institut Universitaire De Cardiologie Et De Pneumologie De Québec (Quebec Heart and Lung Institute), Laval University, Quebec, Canada.
authors.forename: Omar
authors.initials: O
authors.lastname: Abdul Jawad Altisent
authors.affiliation: Institut Universitaire De Cardiologie Et De Pneumologie De Québec (Quebec Heart and Lung Institute), Laval University, Quebec, Canada.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Rinfret
mesh_terms: D020341:Absorbable Implants; D000787:Angina Pectoris / Q000175:diagnosis / Q000209:etiology; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D006328:Cardiac Catheterization / Q000379:methods; D002908:Chronic Disease; D017023:Coronary Angiography / Q000379:methods; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology
keywords: MDCT; chronic total occlusion; percutaneous coronary intervention; radial; transradial