Key result
Retrograde CTO-PCI via septal collaterals achieves successful revascularization in complex RCA in-stent restenosis.
Why the study?
Chronic total occlusions with in-stent restenosis pose significant challenges in interventional cardiology requiring advanced PCI techniques.
Case Report (n=1)
Advanced CTO-PCI techniques, particularly retrograde approaches and intravascular imaging guidance, are critical for achieving successful revascularization in complex cases like severe calcification with in-stent restenosis.
Supports feasibility of retrograde CTO-PCI in complex ISR cases; hypothesis-generating and leaves broader safety and efficacy open.
Chronic total occlusions (CTOs) with in-stent restenosis (ISR) pose significant challenges in interventional cardiology. This case report describes the successful revascularization of a 58-year-old male with an ISR-related CTO of the right coronary artery. After the antegrade approach failed, a retrograde strategy via septal collaterals was employed. Key techniques included retrograde wire crossing, microcatheter support, and intravascular ultrasound-guided stent optimization. Despite severe calcification and bifurcation involvement, strategic planning and hybrid percutaneous coronary intervention (PCI) techniques ensured optimal revascularization. This case highlights the importance of advanced CTO-PCI strategies in managing complex coronary occlusions.
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Gautam Swaroop (2025) conducted a case report in Chronic total occlusion with in-stent restenosis (n=1). Retrograde CTO-PCI strategy via septal collaterals was evaluated on Successful revascularization. Advanced CTO-PCI strategies, including a retrograde approach via septal collaterals, achieved successful revascularization in a patient with a complex ISR-related CTO of the right coronary artery.
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