İpsilateral Epikardiyal Kollateral Kullanılarak Yapılan Başarılı Retrograd LAD-KTO Girişimi: Diyagonal Dal Üzerinden U-Dönüşü Tekniği
Özet
Kronik total oklüzyon (KTO) koroner anjiyografi girişimlerinde, antegrad girişimde başarısızlık olursa retrograd yaklaşım temel stratejidir olmaktadır. Genellikle kontralateral septal kollateraller tercih edilir, ancak bu yolların uygun olmadığı durumlarda ipsilateral epikardiyal yollar kullanılabilir. Bu olguda, sol anterior desenden arter (LAD) proksimalindeki stent içi oklüzyonu, birinci diyagonal daldan (D1) köken alan ve keskin bir "U-dönüşü" ile distal yatağa bağlanan ipsilateral epikardiyal kollateral kullanılarak, retrograd "reverse CART" tekniği ile başarıyla açılan 72 yaşındaki kadın hasta sunulmaktadır.
In coronary angiography procedures for chronic total occlusion (CTO), the retrograde approach is the primary strategy if antegrade access fails. Contralateral septal collaterals are generally preferred; however, ipsilateral epicardial routes may be used when these pathways are unsuitable. This case report presents a 72-year-old female patient in whom a stent-internal occlusion proximal to the left anterior descending artery (LAD) was successfully recanalised using the retrograde ‘reverse CART’ technique, utilising an ipsilateral epicardial collateral originating from the first diagonal branch (D1) and connecting to the distal bed via a sharp ‘U-turn’.
Referanslar
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