{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T09:44:09Z","timestamp":1776764649926,"version":"3.51.2"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The retrograde approach has been integrated into global practice for managing challenging chronic total occlusion (CTO). A fundamental limitation of this technique is the requisite presence of navigable collateral channels. Thus, the incomplete exposure of collateral pathways renders complete interventional revascularisation of multi-vessel CTOs a persistent challenge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 53-year-old man was admitted for unstable angina. Coronary angiography demonstrated three-vessel CTOs, with a long right coronary artery (RCA) CTO, a proximal left anterior descending artery (LAD) CTO, and a CTO in a small-calibre left circumflex (LCX). A staged percutaneous coronary intervention (PCI) approach was adopted. The LAD and LCX CTOs were sequentially revascularized via an antegrade approach. Leveraging optimal visualisation of the collateral channels, particularly an interventional channel from the distal LCX to the RCA, a more challenging RCA CTO was successfully revascularized using a retrograde approach. The patient was symptom-free and was discharged 3 days later.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case highlights the presence of potential interventional collateral channels in a small vessel CTO, which may enhance the success rate of subsequent, more complex CTO interventions via a retrograde approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag241","type":"journal-article","created":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T11:40:23Z","timestamp":1776598823000},"source":"Crossref","is-referenced-by-count":0,"title":["Rethinking small vessel CTOs: collateral channels as a bridge to subsequent complex intervention-a case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0266-9603","authenticated-orcid":false,"given":"Zizhuo","family":"Su","sequence":"first","affiliation":[{"name":"Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University , Guangzhou 510120 ,","place":["China"]},{"name":"Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology , Guangzhou 510120 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiajie","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University , Guangzhou 510120 ,","place":["China"]},{"name":"Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology , Guangzhou 510120 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Woliang","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University , Guangzhou 510120 ,","place":["China"]},{"name":"Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology , Guangzhou 510120 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingfeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University , Guangzhou 510120 ,","place":["China"]},{"name":"Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology , Guangzhou 510120 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9731-6487","authenticated-orcid":false,"given":"Maohuan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University , Guangzhou 510120 ,","place":["China"]},{"name":"Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology , Guangzhou 510120 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"2026042104503167500_ytag241-B1","doi-asserted-by":"crossref","first-page":"94","DOI":"10.4244\/EIJ-D-17-00867","article-title":"Overview and proposed terminology for the reverse controlled antegrade and retrograde tracking (reverse CART) techniques","volume":"14","author":"Matsuno","year":"2018","journal-title":"EuroIntervention"},{"key":"2026042104503167500_ytag241-B2","doi-asserted-by":"crossref","first-page":"e005124","DOI":"10.1161\/CIRCINTERVENTIONS.117.005124","article-title":"Collateral channel size and tortuosity predict retrograde percutaneous coronary intervention success for chronic total occlusion","volume":"11","author":"Huang","year":"2018","journal-title":"Circ Cardiovasc 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trial","volume":"396","author":"Jeger","year":"2020","journal-title":"Lancet"},{"key":"2026042104503167500_ytag241-B6","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1016\/j.jcin.2023.02.011","article-title":"Long-term outcome of drug-coated balloon vs drug-eluting stent for small coronary vessels: PICCOLETO-II 3-year follow-up","volume":"16","author":"Cortese","year":"2023","journal-title":"JACC Cardiovasc Interv"},{"key":"2026042104503167500_ytag241-B7","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1001\/jamacardio.2019.1776","article-title":"Outcomes in patients treated with thin-strut, very thin-strut, or ultrathin-strut drug-eluting stents in small coronary vessels: a prespecified analysis of the randomized BIO-RESORT trial","volume":"4","author":"Buiten","year":"2019","journal-title":"JAMA Cardiol"},{"key":"2026042104503167500_ytag241-B8","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/j.jacc.2021.05.055","article-title":"Global chronic total occlusion crossing algorithm: JACC state-of-the-art review","volume":"78","author":"Wu","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2026042104503167500_ytag241-B9","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1161\/CIRCULATIONAHA.119.039797","article-title":"Guiding principles for chronic total occlusion percutaneous coronary intervention","volume":"140","author":"Brilakis","year":"2019","journal-title":"Circulation"},{"key":"2026042104503167500_ytag241-B10","doi-asserted-by":"crossref","first-page":"101132","DOI":"10.1016\/j.cpcardiol.2022.101132","article-title":"Trends and in-hospital outcomes of patients admitted with ST elevation myocardial infarction and chronic total occlusions: insights from a National Database","volume":"48","author":"Nagalli","year":"2023","journal-title":"Curr Probl Cardiol"}],"container-title":["European Heart Journal - Case 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