In-stent chronic total occlusion (CTO) represents a challenging lesion subset for percutaneous coronary intervention (PCI), and although a true-to-true lumen crossing is the first-line strategy, a subadventitial approach may become necessary. Here we describe a case of successful in-stent right coronary artery CTO-PCI performed with subadventitial crossing, crushing of the occluded stents, and advancement of a mother-and-child catheter to the distal right coronary artery through the subadventitial space to allow stent delivery. The use of intracoronary imaging in this setting proved crucial to confirm adequate apposition of the newly implanted stents and optimal crushing of the occluded stents.
|Journal||Journal of Invasive Cardiology|
|Publication status||Published - 2017|