Document Detail

Coronary septal collaterals as an access for the retrograde approach in the percutaneous treatment of coronary chronic total occlusions.
MedLine Citation:
PMID:  17253598     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To investigate the feasibility and safety of the percutaneous dilatation of coronary septal collaterals and to allow its use as an access for retrograde approach to percutaneous coronary intervention (PCI) of coronary chronic total occlusions (CTOs). BACKGROUND: Despite improvements in percutaneous techniques and materials, CTO recanalization success rate is still suboptimal. The retrograde approach allows to significantly increase this success rate. However, its application via a bypass graft or epicardial collateral can potentially result in severe complications. A safer retrograde access is desired and would allow broadening the application of the retrograde approach in the percutaneous treatment of CTOs. METHODS: After a failed antegrade CTO recanalization attempt, a retrograde approach via septal collaterals was tried in 21 patients (19 males, 2 females). The septal collateral was accessed via the contralateral patent coronary artery and was crossed with a hydrophilic floppy wire. After successful wire crossing of the septal collateral, sequential low pressure dilatation was performed with a 1.25 or 1.5 mm balloon to allow the delivery of a balloon catheter up to the distal CTO site. RESULTS: Successful wire crossing and balloon dilatation of septal collaterals was achieved in 19 cases and in 17 cases, respectively. Postdilatation septal collateral diameter increased significantly reaching a mean diameter of 1.46 +/- 0.38 mm. Retrograde CTO recanalization was successfully performed in 71% of the cases. No major complications occurred. CONCLUSIONS: Coronary septal collaterals can be used as an access for the retrograde approach in the percutaneous treatment of CTOs.
Jean-François Surmely; Osamu Katoh; Etsuo Tsuchikane; Kenya Nasu; Takahiko Suzuki
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  69     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-01     Completed Date:  2007-06-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  826-32     Citation Subset:  IM    
Copyright Information:
(c) 2006 Wiley-Liss, Inc.
Department of Cardiology, Toyohashi Heart Center, Toyohashi, Aichi, Japan.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects,  methods*
Chronic Disease
Collateral Circulation*
Coronary Angiography
Coronary Circulation*
Coronary Disease / physiopathology,  radiography,  therapy*
Feasibility Studies
Heart Septum / physiopathology*,  radiography
Middle Aged
Radiography, Interventional
Treatment Outcome
Vascular Patency

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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