Application of dual lumen microcatheters in chronic total occlusion percutaneous coronary interventions – lessons learned from a complex case
█ Case report
Tajti Péter1, Rami Abu Fanne2, Ungi Imre1, Katona András1, Sasi Viktor1, Nagy Ferenc Tamás1
1Szegedi Tudományegyetem, Invazív Kardiológiai Részleg, II. sz. Belgyógyászati Klinika és Kardiológiai Központ, Szeged
2Hillel Yaffe Medical Center, Hadera, Izrael
The success rate and safety of percutaneous coronary intervention (PCI) of chronic total coronary occlusions (CTO) in dedicated CTO centers has significantly improved recently. History of prior coronary artery bypass graft surgery (CABG) in patients undergoing CTO PCI is associated with lower procedural success and higher rates of major procedural complications. Increased complexity of coronary anatomy requires the use of advanced interventional techniques and devices in order to achieve successful CTO revascularization safely and effectively in such a challenging patient population. In our current case we present a complex right coronary CTO recanalization in a patient with a history of CABG surgery who had undergone two previous failed antegrade CTO attempts in an outside hospital. Given the complexity of the distal right coronary artery bifurcation and pre-branch saphenous vein graft (SVG) anastomosis we used the dual lumen microcatheter in a unique way both retrogradely and antegradely to preserve side-branches and achieve success.