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Antegrade/Retrograde LM Stenting in LM CTO

Learn about antegrade/retrograde left main artery stenting for LM CTO from Dr. Ricardo Vicuna, Dr. Paul Silverman, and Dr. Bruce Abramowitz. Explore a case presentation of a 55-year-old man with angina and previous CABG, illustrating techniques, challenges, and outcomes. Discover key take-home points for successful LM CTO interventions.

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Antegrade/Retrograde LM Stenting in LM CTO

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  1. ANTEGRADE/RETROGRADE LEFT MAIN ARTERY STENTING Ricardo Vicuna, MD Paul Silverman, MD Bruce Abramowitz, MD

  2. Antegrade/Retrograde LM stenting : History • 55 year old man with worsening angina despite maximal medical therapy • PMHx HTN, hyperlipidemia • Emergent CABG 4 months prior to current admission • Grafts LIMA-LAD • SVG-PDA • SVG-Diagonal

  3. Antegrade/Retrograde LM stenting: Case Presentation No LM ostium

  4. Antegrade/Retrograde LM stenting: Case Presentation Retrograde wire into LM and Ao

  5. Antegrade/Retrograde LM stenting: Case Presentation

  6. Antegrade/Retrograde LM stenting: Case Presentation Antegrade/Retrograde Wires into LM

  7. Antegrade/Retrograde LM stenting: Case Presentation Final Result

  8. Antegrade/Retrograde LM stenting: Take Home Points • Retrograde determination of the origin of LM CTO can be achieved with a guidewire if the standard antegrade approach proves to be unsuccessful • Antegrade recanalization of the LM CTO can then be attempted after confirmation of the intraluminal location of the two guidewires

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