title: Successful Revascularization of an LCx CTO Lesion by Retrograde Approach From an Acute Thrombotic SVG Without Protection Device in an ACS Patient.
abstract: We describe a patient who underwent coronary artery bypass grafting (CABG) surgery with the presentation of acute coronary syndrome (ACS). The diagnostic coronary angiogram showed acute thrombotic and occluded saphenous vein graft (SVG) and proximal right coronary artery (RCA) drug eluting stent (DES) instent restenosis (ISR) with chronic total occlusion (CTO). Our strategy was to recanalize the native left circumflex coronary artery (LCx) CTO instead of SVG or RCA instent CTO. After heparinization for 5 days, the LCx antegrade approach and the retrograde approach from left anterior descending coronary artery (LAD) septal branches were first attempted but failed, and the LCx CTO was successfully revascularized retrogradely via the acute thrombotic SVG without an embolic protection device (EPD).
authors.affiliation: Department of Cardiology, Buddhist Tzu Chi General Hospital.
authors.forename: Mei Mei
authors.initials: MM
authors.lastname: Lin
authors.forename: Ji Hung
authors.initials: JH
authors.lastname: Wang
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome