Video: Triple-Access Retrograde CTO Treatment Via Vein Graft and Epicardial Collaterals

Video Supplement to “Triple-Access Retrograde Chronic Total Occlusion Intervention Through Vein Graft and Epicardial Collaterals,” by Tsiafoutis, et al. (June 2020 Clinical Images).

A decision was made to recanalize this patient's totally occluded RCA via retrograde approach through the SVG to the OM. Due to inadequate visualization of the epicardial collaterals and distal RCA via SVG, triple-access was used with injection via left main. Subsequently, an antegrade approach successfully crossed the CTO using the “just marker” technique. Finally, three drug-eluting stents were implanted with good angiographic result, which is demonstrated herein.