Sequential Dual Guide Catheter Technique for Chronic Total Occlusion Interventions in Patients With Prior Coronary Artery Bypass Graft Surgery

Catheter Cardiovasc Interv. 2025 Jan;105(1):120-123. doi: 10.1002/ccd.31325. Epub 2024 Dec 10.

Abstract

Triple arterial access is sometimes necessary for complete visualization of the collateral circulation and distal vessel anatomy, and to facilitate the retrograde approach in complex chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in patients with prior coronary artery bypass surgery (CABG) and multiple sources of collaterals. We present two CTO PCI cases in prior CABG patients with complex occlusions supplied by multiple sources of collaterals for which a "sequential dual guide technique" was used, reducing the number of necessary arterial access points from three to two.

Keywords: CORG ‐ coronary bypass grafts; CTO; CTO ‐ percutaneous coronary intervention; PCIC ‐ percutaneous coronary intervention; complex PCI.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cardiac Catheterization / instrumentation
  • Cardiac Catheters
  • Chronic Disease
  • Collateral Circulation*
  • Coronary Angiography*
  • Coronary Artery Bypass* / adverse effects
  • Coronary Circulation
  • Coronary Occlusion* / diagnostic imaging
  • Coronary Occlusion* / physiopathology
  • Coronary Occlusion* / therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / instrumentation
  • Treatment Outcome