Retrograde balloon crossing to overcome antegrade delivery failure for a heavily calcified chronic total occlusion

Publication date: Available online 17 December 2018Source: Journal of Cardiology CasesAuthor(s): Kenji Sadamatsu, Kensuke Oe, Toshiya Muramatsu, Hideki TashiroAbstractWe herein report a case of percutaneous coronary intervention to a heavily calcified chronic total occlusion in the left anterior descending artery. Although we successfully performed retrograde wire crossing and wire externalization, we were unable to deliver small-sized balloon catheters in the lesion antegradely, even with strong back-up of wire externalization because of the heavy calcium mass. However, a balloon catheter was easily crossed retrogradely, and the lesion was successfully treated. Thus, retrograde balloon crossing might be a way to overcome device delivery failure in calcified lesions.<Learning objective: Dense calcium often prevents devices from passing through a chronic coronary total occlusion. In the present case, retrograde delivery through an epicardial collateral channel succeeded in balloon crossing, because changing the direction reversed the distribution of calcium for the passage.>
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research