“Retrograde Plaque/Flap Lift-and-Shift” Technique to Exclude Coronary Artery Aneurysm at the Proximal Cap of Chronic Total Occlusion of the Right Coronary Artery: A Case Report

With growing expertise and evolving hardware chronic total occlusion (CTO) percutaneous coronary intervention (PCI) success and safety has been improved remarkably. The nuances of CTO wiring help operators to find novel solutions to the complications created during percutaneous coronary interventions. Accidental coronary perforations caused during CTO interventions can be sealed by wiring from other side and shifting interposing plaque or flap onto perforation. We report a case of saccular aneurysm around the proximal cap formed by antegrade wire escalation in earlier failed percutaneous coronary interventions, which is excluded by “retrograde plaque lift and shift.”