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. 2016 Sep 7;2016:8750603. doi: 10.1155/2016/8750603

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Copyright © 2016 Abdul-rahman R. Abdel-karim et al.

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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(a) Right coronary artery (RCA) chronic total occlusion (CTO). (b) Left anterior descending artery (LAD) supplying Werner's grade 1 septal collaterals to RCA CTO. (c) Fielder FC (arrow) advanced from LAD through second septal perforator into distal RCA. (d) After successful retrograde wire crossing, externalization was achieved with guidewire (arrow). (e and f) Angiogram of LAD and RCA, respectively, reveals Ellis Type III septal collateral perforation (arrows) into the right ventricle. (g) Negative suction applied to Corsairs (arrow heads) that were advanced from LAD and RCA into the perforated septal collateral. (h) Detachable coil delivered (arrow) but persistent of perforation seen (arrow head). (i) Covered stent (arrow) delivered across perforated septal vessel. (j and k) Final angiogram of LAD and RCA, respectively, confirmed resolution of septal perforation.