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Stenting after retrograde recanalization of  Ao-RCA bypass   and  LAD  chronic total occlusion . Case presentation А.  Osi...
Collaterals  Cx - RCA Clinical background <ul><li>61 year old female </li></ul><ul><li>Stable angina III </li></ul><ul><li...
Antegrade attempt was unsuccessful During the procedure antegrade recanalization of   RCA: -blood pressure sharply decreas...
Coronary wire :  LCA –  С x – RCA  -   Ao-RCA   bypass  -  aortic arch. Balloon dilatation .   Antegrade  stent implantati...
After stent implantation 5 BMS : - relief of chest pain  -restoration of blood pressure
Follow up 4 months Results  : - reocclusion CABG  - return angina Implantation of  4  DES
Follow up  10  months Results :  restenosis DES  Laser ablation . Excimer laser   catheter  « Spectranetics » . The final ...
The next step ???
Retrograde catheterization of  LAD  with coronary wire  and Corsair catheter (Asahi Intecc)  Collaterals  DA-LAD
Coronary wire with   Corsair  catheter  in   Ao-DA bypass -  DA-  LAD
Coronary wire was trapped by “goose neck” retriver. Right femoral artery –  Ao-DA bypass -  DA-  LAD – Left femoral artery...
Follow up 1 year  LAD without significant restenosis Ao-RCA   bypass without  significant restenosis
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Осиев А.Г. "Клинический случай"

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Осиев А.Г. "Клинический случай"

  1. 1. Stenting after retrograde recanalization of Ao-RCA bypass and LAD chronic total occlusion . Case presentation А. Osiev Novosibirsk State Research Institute Of Circulation Pathology Ministry of Health and Social Development of the Russian Federation
  2. 2. Collaterals Cx - RCA Clinical background <ul><li>61 year old female </li></ul><ul><li>Stable angina III </li></ul><ul><li>CABG LAD, DA, RCA 1997 </li></ul><ul><li>Positive stress test </li></ul><ul><li>Risk factors: Hypertension, dislipidemia </li></ul><ul><li>ECHO: inferior hypokinesia </li></ul><ul><li>Angio : occlusion LAD , occlusion RCA ; normal function Ao-DA bypass, occlusion Ao-RCA bypass, occlusion Ao-LAD bypass. </li></ul>
  3. 3. Antegrade attempt was unsuccessful During the procedure antegrade recanalization of RCA: -blood pressure sharply decreased from 140 torr to 70 torr -severe chest pain
  4. 4. Coronary wire : LCA – С x – RCA - Ao-RCA bypass - aortic arch. Balloon dilatation . Antegrade stent implantation What to do now in this situation? Our response : we decided to perform a retrograde recanalization CABG?!
  5. 5. After stent implantation 5 BMS : - relief of chest pain -restoration of blood pressure
  6. 6. Follow up 4 months Results : - reocclusion CABG - return angina Implantation of 4 DES
  7. 7. Follow up 10 months Results : restenosis DES Laser ablation . Excimer laser catheter « Spectranetics » . The final result
  8. 8. The next step ???
  9. 9. Retrograde catheterization of LAD with coronary wire and Corsair catheter (Asahi Intecc) Collaterals DA-LAD
  10. 10. Coronary wire with Corsair catheter in Ao-DA bypass - DA- LAD
  11. 11. Coronary wire was trapped by “goose neck” retriver. Right femoral artery – Ao-DA bypass - DA- LAD – Left femoral artery loop was formed After stent implantation
  12. 12. Follow up 1 year LAD without significant restenosis Ao-RCA bypass without significant restenosis

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