Work

Septal Collaterals in a Chronic Total Occlusion

Year: 2025

Type: article

Abstract: OBJECTIVE: Percutaneous coronary intervention of a chronic total occlusion (CTO) should be considered in patients with angina or with documented ischemia. We present a patient with angina and stress echocardiography positive for ischemia in the anterior wall. KEY STEPS: The coronary angiography revealed a CTO in the left anterior descending artery, and a percutaneous approach was decided. The antegrade dissection reentry was unsuccessful. Retrogradely, through the ipsilateral septal collaterals, a SUOH wire was successfully advanced distally to the CTO. Externalization of the RG3 was successful, and the antegrade microcatheter was advanced inside the distal septal. Successful percutaneous coronary intervention of the left anterior descending artery was performed. POTENTIAL PITFALLS: Ping pong technique was not used, making the procedure challenging for equipment delivery. TAKE-HOME MESSAGES: One injection, one solution technique can be applied in selected cases with ipsilateral septal collaterals. Careful evaluation of the coronary anatomy before the procedure is mandatory.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.104926

Authors: Panagiotis Varelas, Konstantinos Manousopoulos, Konstantinos Filippou, Dimitrios Karelas, Ioannis Papadopoulos, Ioannis Tsiafoutis

Institutions: Hellenic Red Cross, Red Cross Hospital

Language: English

Topic: Coronary Interventions and Diagnostics

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850