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Retrograde approach to successfully treat antegrade failure due to subintimal hematoma of a right coronary artery chronic total occlusion

F Latif, ES Brilakis & J Exaire

Use of antegrade dissection re-entry techniques for crossing coronary chronic total occlusions may occasionally fail due to subintimal hematoma formation. We describe use of the retrograde approach to successfully complete a right coronary artery chronic total occlusion intervention, in which re-entry was not possible after subintimal guidewire crossing due to extensive subintimal hematoma formation that compressed the distal true lumen.