Antegrade recanalization of a CTO with severe calcification of the right coronary artery

Dr. Franco Javier Vallejo

Head of Haemodinamics of Camino Distrital Adelita de Char, Barranquilla, Colombia.

Introduction

With the introduction of new therapies, such as microcatheters and recanalisation guidewires, the success rate of treatment for chronic coronary occlusions has increased. We describe a successful case with the use of the Navitian microcatheter via the right radial approach.

Patient profile

36-year-old woman.
History of inferior wall MI with ST elevation 10 years ago with angioplasty and stent placement in the right coronary artery.

Lesion type

Occlusion from the origin of the right coronary artery (J-CTO score of 3) with severe calcification and total occlusion (Figure 1).

Procedure

The right coronary ostium was cannulated with an IL guiding catheter.
Navitian microcatheter was introduced, offering good navigation over the 6F guide catheter, and the two 0.014 recanalization guidewires, Fighter/Hornet 10, were easily passed through it (Figure 2).
Thanks to Navitian, it was possible to advance satisfactorily to the distal third of the native vessel and cross the occlusion (Figure 3).
Successful recanalization of the right coronary artery (Figure 4).

Conclusion

“Adequate support was achieved for passing the 0.014 guidewires, and it was possible to advance the Navitian microcatheter to the distal third of the occlusion thanks to its satisfactory design: good profile and support on the occlusion stump without deforming. Navitian allowed adequate exchange of the guidewires for angioplasty and stent insertion.”

Dr. Franco Javier Vallejo
Camino Distrital Adelita de Char, Barranquilla, Colombia
General del Norte Barranquilla, Colombia

Figures