Gasparini GL, Oreglia JA, and Reimers B
Chronic total coronary occlusions (CTO) still remain one of the most technically challenging clinical scenarios in which to perform interventions. Although the antegrade approach is the most common method of CTO recanalization, a retrograde attempt improves the success rate and its usage has been increasingly adopted in the recent years. Furthermore, abnormalities such as anomalous origin coronary arteries represent other important technically challenging cases for interventional cardiologist. In this case, we describe a rare case of a CTO in the mid portion of an anomalous right coronary artery (RCA), that originated from a high anterior takeoff and progressed in the downward direction, where retrograde approach has been used to overcome the absence of antegrade guiding catheter support.
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