2b) with a good final angiographic result ( Fig. ![]() 2a), and a 2.5 mm × 38 mm Xience Xpedition (Abbott Vascular, Santa Clara, California, USA) stent was deployed ( Fig. Serial predilatations with 1.5 mm × 15 mm and 2.0 mm × 15 mm semi-compliant balloons were performed ( Fig. Therefore, a 5-in-6 Fr Guideliner catheter was passed into the mid-RCA and a Pilot 150 (Abbott Vascular, Santa Clara, California, USA) wire crossed the CTO with a 1.0 mm × 10 mm Falcon CTO (Invatec, Roncadelle, Italy) balloon support ( Fig. Therefore, anterograde angioplasty of the RCA CTO was performed from the radial artery using a 6 Fr JR guiding catheter that provided poor support, and the occlusion was not successfully crossed ( Fig. The distal RCA was observed to backfill following a contralateral injection of the left coronary artery. After obtaining informed consent, coronary angiography performed through the TRA revealed an occlusion of the mid-RCA just distal to the previous stent. In this case report, we applied the Guideliner mother-and-child catheter (Vascular Solutions, Minneapolis, Minnesota, USA) to successfully treat a case of CTO performed through the TRA.Ī 69-year-old female with a past medical history of hypertension, dyslipidemia, coronary artery disease and a coronary angioplasty with two drug-eluting stents in the proximal first obtuse marginal artery and the mid-right coronary artery (RCA) 8 years previously presented to our hospital with recurrent angina and was referred for cardiac catheterization. 4 Different strategies have been emerging to resolve the problem of inadequate guide catheter support: the use of high-support guidewires, techniques involving buddy wires and "mother-and-child" guide catheter extension systems among others. The transradial approach (TRA) for PCI has been shown to have benefits that include shorter hospital stays and a reduction in vascular complications 3 however, coronary anatomic variations and the lack of guide catheter support increase the technical complexity. 2 The use of the transfemoral arterial approach (TFA) is the commonly accepted method for CTO interventions because this approach provides better support. Percutaneous coronary interventions (PCIs) for CTO are currently performed with improving success rates and low complication rates. 1 The successful revascularization of a CTO is associated with a reduction in angina symptoms and better long-term survival. Servicio de Cardiología, Hospital de Jerez de la Frontera,Ĭircunvalación s/n, 11407 Jerez de la Frontera, Cádiz, Spain.Ĭhronic total occlusions (CTOs) are present in 15≣0% of patients who undergo coronary angiography. Javier Benezet *, Alejandro Gutiérrez-Barrios, Antonio Agarrado y Jesús Onetoĭepartment of Cardiology, Hospital de Jerez de la Frontera, Jerez de la Frontera, Cádiz, Spain. ![]() Revascularización anterógrada mediante acceso arterial radial de una oclusión total crónica de la arteria coronaria derecha usando un catéter Guideliner Transradial anterograde recanalization of a totally occluded right coronary artery using a Guideliner catheter
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