Stumpless Ostial Right Coronary Artery Chronic Total Occlusion: Retrograde Approach

Percutaneous coronary interventions of the coronary total occlusions, especially of the aor-to-ostial lesions, pose challenges. Since antegrade wiring is not feasible in aorto-ostial chronic total occlusions, retrograde wiring remains the lone strategy. We present a successful case of stumpless ostial right coronary artery chronic total occlusion, which was successfully opened by retrograde wiring and externalization by snaring. Intravascular ultrasound was performed to comprehend the diffusely narrowed distal right coronary artery and the posterior left ventricular branch to guide the stenting strategy in percutaneous coronary intervention.