Retrograde Recanalization of mid LAD CTO - March 2022

59-year-old male presented with CCS Class IV angina and coronary CTA revealing total mid LAD occlusion. A Cardiac Cath on February 25, 2022 revealed 1 V CAD: total occlusion of mid LAD with distal vessel filling antegradely and retrogradely with EF = 65% and SYNTAX Score of 12. Patient underwent unsuccessful intervention of mid LAD CTO via antegrade approach. Now planned for stage PCI of mid LAD CTO via RCA collaterals using retrograde approach.

[@SworajYadav]

Superb

[@alirhayim]

Fantastic. Really enjoyed this case.

[@sjn8099]

Great work 🙂

[@zemos777]

Why not leaving a wire in the diagonal branch for protection in case the retrograde wire went subintimal which can compromise that diagonal Branch

[@rpathansir]

Hello sir my name is Rahim Pathan my age is 48 I have diabetes and blood pressure. I have both blockages and all the blocks are closed. I had angioplasty in LAD $ RCA, I tried both LAD several years ago but it was not successful, the doctors there told me I only gave you medicine. But after doing some work I feel tired and my blood pressure suddenly increases, sometimes I do not feel scared while walking, sometimes it happens. But after a little increase in BP and feeling unwell, the doctor advises to do bypass or mini bypass. But I got some report from another hospital i.e. SMBT hospital Nashik or some other place and I read the report from the doctor that you can undergo Angioplasty Rotational Surgery, sir I am very confused as to what should be done because if there is any other treatment apart from bypass, please tell me. . This is your request