The feasibility of transradial laser atherectomy for chronic total occlusion using the 5 Fr sheath system.
OBJECTIVE
We present a case of chronic total occlusion (CTO) approached with LASER endovascular intervention by radial artery approach using a 5 French sheath.


METHODS
A 57-year-old man presented to our hospital having had retrosternal chest pain for two days. Physical examination was normal at the time of presentation. The laboratory tests were within normal limits, including cardiac enzymes except the lipid panel which showed hypertriglyceridemia. The patient underwent a myocardial perfusion scintigraphy stress test that revealed inferior wall ischemia, with normal left ventricular ejection fraction. A 5-French vascular sheath was placed in the right radial artery. Selective coronary artery angiography was performed, which showed right coronary artery (RCA) CTO. A 5-French JR4 guide catheter successfully engaged the RCA and Laser angioplasty was performed across the CTO into the RCA. A marked improvement of flow was evident thereafter.


CONCLUSIONS
To best of our knowledge this is the first case report showing the feasibility of laser atherectomy using the 5 French sheath system in a coronary arterial CTO.
Internal Medicine Department-Texas Tech University Health Sciences Center, Lubbock, TX, USA. k_a_sherif@hotmail.com.
Khaled
K
Sherif
Internal Medicine Department-Texas Tech University Health Sciences Center, Lubbock, TX, USA.
Yasir
Y
Yaqub
Internal Medicine Department-Texas Tech University Health Sciences Center, Lubbock, TX, USA.
Jose A
JA
Suarez
D017073:Atherectomy / Q000295:instrumentation / Q000379:methods*; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods*; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000175:diagnosis / Q000628:therapy*; D005240:Feasibility Studies; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017534:Radial Artery; D016896:Treatment Outcome
Chronic total occlusion; Coronary artery disease; LASER endovascular intervention