A62-year-old patient with a burdened cardiovascular history. Occasionally notesan increase in blood pressure to 180 and 110 mm. rt. Art. post-infarctioncardiosclerosis of unknown duration. The condition worsens over several monthsas exercise tolerance decreases.

The patientunderwent attempted recanalization of the right coronary artery 3 months ago.Using a retrograde coronary guidewire, it was possible to recanalize the distaland proximal plaque covers. A Tip-in the antegrade guide catheter was alsoperformed; however, the retrograde coronary guidewire fell under the cell ofthe previously implanted stent. Then the decision was made to stop.This time,it was possible to recanalize the proximal plaque cover antegradely, however,it was not possible to enter the true lumen of the right coronary artery. Thedecision was made to perform a retrograde approach. a retrograde rigid coronaryguidewire  managed to pass into themiddle segment of the right coronary artery. Using the technique of kissing-wires,it was possible to enter the true lumen of the artery antegrade. For bettersupport, a tip-in was made in the septal branch into the Finecross microcatheterwith an antherad conductor. then, with the support of a Guideliner, aggressivepredilation was performed with a 2.0x15mm balloon catheter with a pressure ofup to 25 atm. Next, 3 DES were implanted with good angiographic results. 

Anteriorly,when passing the coronary guidewire in the subintimal space, in order topreserve the lateral branches and also the distal segment of the artery, it isbetter to use the retrograde recanalization technique.