Comparison of relative safety and efficacy of handmade S-shaped catheter and conventional catheters in concomitant carotid and coronary angiography.

BACKGROUND: We have evaluated the feasibility of concomitant carotid angiography after coronary angiography with the same catheter, and the practicality, safety and success of image acquisition with respect to conventional catheters. METHOD: 248 patients have been enrolled in the study, who have been evaluated with both carotid and coronary angiography in a time period between 2010 and 2017. 117 of them were evaluated with right diagnostic catheters and 131 of them were evaluated with handmade S shaped (HMS) catheters. Basic parameters were similar in both of the groups. Total procedural time (7.34 ± 1.10 vs 9.56 ± 3.59 minutes, p < 0.001), fluoroscopy use time (6.08 ± 1.72 vs 5.23 ± 1.00 minutes, p < 0.001), used contrast media volume (50.2 ± 15.6 mL vs 62.3 ± 17.9 mL, p < 0.001) were all lower in the HMS catheter group. CONCLUSION: There is strong correlation between coronary and carotid artery disease (62%). Many Cardiologists perform concomitant carotid angiography when performing coronary angiography using right diagnostic catheters (JR). The JR catheters tip can be reshaped like to S to enhance its safety and efficacy during carotid imaging. Our experience supports this. Imaging of the carotid arteries is advantageous for the patients with severe coronary artery disease, when performing coronary angiography. For this purpose, the same catheter used for coronary imaging can be used after it is reshaped at hand, in place of a special catheter. This method is both efficient and safe.

Successful Retrograde Visualization and Recanalization of Chronic Ostial Occlusion of the Left Main Coronary Artery via a Saphenous Vein Graft With the Drilled Balloon Technique.

We are representing a case of successful retrograde recanalization of a chronic ostial occlusive lesion of the left main coronary artery (LMCA) via a saphenous vein graft. A 70-year-old male patient, with a history of previous (3 years ago) coronary artery bypass surgery, was evaluated with coronary angiography because of his recent anginal symptoms. Left main coronary artery could not be visualized from the aortic root. It could be visualized with drilled balloon technique which was introduced retrogradely from a saphenous vein graft, and the chronic ostial lesion of the LMCA could be treated with balloon dilatation and stenting. Coronary occlusions can be treated retrogradely via the native collaterals and grafts. The coronaries that are not visualized with an antegrade fashion can be visualized with a retrograde way with the drilled balloon introduced through a patent graft. We could not find any publication about this technique on the web-based research. When encountered with a totally occluded ostial lesion of the LMCA, that cannot be visualized even from the aortic root, it may be tried to be visualized through a patent graft retrogradely. This is a safe and reliable method in patients with a total occlusion of the LMCA who also have a patent saphenous vein graft.