Retrograde Recanalization of Chronic Coronary Occlusions by Furkalo SN in Advancements in Cardiovascular Research in Lupine Publishers
Chronic coronary occlusion (CTO) is fixed at 1 in 5 patients who
underwent cardiac catheterization. Recanalization of chronic
coronary occlusions is one of the most difficult for the technical
performance of interventional procedures. Successful recanalization
CTO associated with better survival compared to patients where the
procedure of recanalization of occlusion was not successful.
Thus, potential candidates for retrograde recanalization of chronic
occlusions of coronary arteries may be: patients after a failed
attempt of recanalization with clear indications and motivated to
implement PCI; refractory angina with CTO of native coronary
arteries after CABG; single-vessel coronary artery disease - RCA or the
LAD with preserved left ventricular function and preserved
kidney; patients with multivessel disease and related comorbidity, which
does not allow to perform coronary artery bypass surgery.
From 2007 to the present time we have carried out 125 of retrograde
recanalization of chronic occlusions of coronary arteries with
a total efficiency of 66.4%. Our data suggest that CTO intervention most
often used in LAD - 50% of the RCA - 41.7%, and LCx - in
8.3% of cases. It was succesfull method in CTO cases of RCA - in 86.6%
of cases, LAD - in 66% of patients and occlusion and in case
of Cx CTO recanalization was succesfull in only 2 patients. Septal
collaterals with retrograde approach used in most cases- 101
patients, epicardial collaterals - in 19 cases, and in 4 cases of
retrograde access served venous bypass and one mammary coronary
bypass – to the LAD.
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