Feasibility of facilitated antegrade dissection with Stingray-based re-entry for coronary chronic total occlusions with previously stented graft-to-native-vessel anastomoses
- PMID: 36229936
- DOI: 10.1002/ccd.30426
Feasibility of facilitated antegrade dissection with Stingray-based re-entry for coronary chronic total occlusions with previously stented graft-to-native-vessel anastomoses
Abstract
Facilitated antegrade dissection re-entry (F-ADR) is a technique described for treating post coronary artery bypass surgery chronic total occlusions (CTO) when there is flush occlusion of the distal cap of the CTO at the vein graft anastomosis. In this scenario retrograde access is usually impossible and if antegrade wiring fails, F-ADR is then the best option. Following antegrade dissection past the anastomosis, a balloon is delivered via the vein graft and inflated in the native vessel distal to the anastomosis to facilitate re-entry using a Stingray catheter. However, the applicability and outcome of this technique have not been described in cases where the graft to native vessel anastomosis has previously been stented. We report a case series of successful CTO recanalization using F-ADR across stented graft-native vessel anastomoses.
Keywords: Complex PCI; chronic total occlusion (CTO); percutaneous coronary intervention (PCI); stenting technique.
© 2022 Wiley Periodicals LLC.
References
REFERENCES
-
- Wilson WM, Walsh SJ, Yan AT, et al. Hybrid approach improves success of chronic total occlusion angioplasty. Heart. 2016;102(18):1486-1493.
-
- Vanhaverbeke M, Eertmans W, Holvoet W, et al. Contemporary strategies and outcomes of dedicated chronic total occlusion percutaneous coronary intervention programs: a prospective multicentre registry. J Interv Cardiol. 2021;2021:8042633.
-
- Aljabbary T, Katyukha A, Elbaz-Greener G, et al. Overview of contemporary chronic total occlusion percutaneous coronary intervention techniques: a narrative systematic review. CJC Open. 2021;3(10):1273-81.
-
- Danek BA, Karatasakis A, Karmpaliotis D, et al. Use of antegrade dissection re-entry in coronary chronic total occlusion percutaneous coronary intervention in a contemporary multicenter registry. Int J Cardiol. 2016;214:428-437.
-
- Michael TT, Karmpaliotis D, Brilakis ES, et al. Impact of prior coronary artery bypass graft surgery on chronic total occlusion revascularisation: insights from a multicentre US registry. Heart. 2013;99(20):1515-1518.