Intracoronary snaring to overcome severe tortuosity in chronic total occlusion percutaneous coronary intervention

Abstract

Severe tortuosity poses a challenge for chronic total occlusion (CTO) operators and decreases the success rate of CTO percutaneous coronary intervention (PCI). Extreme angulations are more common in patients with prior coronary artery bypass surgery (CABG) especially at the distal graft anastomosis. We present three challenging CTO PCI cases performed in patients with prior CABG during which intracoronary snaring was implemented to overcome severe tortuosity and successfully recanalize the occlusions.