Stumpless ostial right coronary artery chronic total occlusion: Retrograde approach

Percutaneous coronary interventions of the coronary total occlusions, especially of the aorto-ostial lesions, portray challenges. As the antegrade wiring is not feasible in aorto-ostial chronic total occlusions, the 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 posterior left ventricular branch (PLVB) to guide stenting strategy in percutaneous coronary intervention.