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CASE20210819_007

Endovascular Reconstruction of a Chronically Occluded Saphenous Venous Graft Using Combined Antegrade and Retrograde Injection

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Presenter

Harinder K. Bali

Authors

1, 1

Affiliation

, India1
Complex PCI - Chronic Total Occlusion

Endovascular Reconstruction of a Chronically Occluded Saphenous Venous Graft Using Combined Antegrade and Retrograde Injection

1, 1

, India1

Clinical Information

Patient initials or Identifier Number

C2 CTO

Relevant Clinical History and Physical Exam

85 years old male presented with progressive angina and LV Dysfunction.
Had undergone CABG with SVG to RCA 5 years  ago. 
Physical examination revealed HR of 82/min, BP 120/80 mmHg, normal S1, S2, no added heart sounds or murmurs. 


Relevant Test Results Prior to Catheterization

Relevant Catheterization Findings

CAG revealed diffusely diseased and chronically occluded SVG to RCA 


Interventional Management

Procedural Step

Through the femoral arterial route, endovascular reconstruction of the chronically occluded saphenous venous graft to the right coronary artery  was done using 3 drug eluting stents. 
Combined Antegrade and retrograde injections were taken. 
This combined technique  was used for the same as only retrograde technique was deemed as not possible in this case. 
Procedure was successful and patient was discharged after one day, and remined stable on follow up visits.                                                                                      









Case Summary

Endovascular reconstruction of a chronically occluded RCA SVG done with 3 DES. Combined retrograde and antegrade injections are an important tool in tackling difficult CTO’s  with ambiguous anatomy.