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Ribeiro et al. Vessel Plus 2019;3:21 Vessel Plus
DOI: 10.20517/2574-1209.2018.66

Case report Open Access

Moderator band connections: an unusual route
in retrograde chronic total occlusion procedure:

moderator band connections as options to right
coronary artery chronic total occlusion

Marcelo H. Ribeiro , Luis A. P. Dallan , Expedito E. Ribeiro da Silva , Carlos M. Campos , Marouane
2
2
1,2
1,2
Boukhris , Alfredo R. Galassi , Daniel Weilenmann , João Antônio Brum da Silveira , Satoru Sumitsuji 6
3
4
5
3
1 Interventional Cardiology Department, SOS CARDIO Hospital, Florianopolis, SC, 88030-000, Brazil.
2 Interventional Cardiology Department, Heart Institute (InCor) – University of Sao Paulo Medical School, Sao Paulo, SP, 05403-
900, Brazil.
3 Interventional Cardiology Department, University of Catania, Catania, 95124, Italy;
4 Interventional Cardiology Department, Saint Gallen Hospital, Saint Gallen, CH-9007, Switzerland.
5 Interventional Cardiology Department, Centro Hospitalar do Porto, Hospital de Santo Antônio, Porto, 4099-001, Portugal.
6 Interventional Cardiology Department, Osaka University, Osaka, 565-0871, Japan.
Correspondence to: Luis Augusto Palma Dallan. InCor - Heart Institute - HCFMUSP - University of Sao Paulo Medical School –
Department of Interventional Cardiology Av Dr. Eneas de Carvalho Aguiar, 44 - Pinheiros - Sao Paulo, SP, 05403-900 Brazil.
E-mail: luisdallan@yahoo.com
Received: First Decision: Revised: Accepted: Published: x How to cite this article: Ribeiro MH, Dallan LAP, da Silva EER, Campos CM, Boukhris M, Galassi AR, Weilenmann D, da Silveira
JAB, Sumitsuji S. Moderator band connections: an unusual route in retrograde chronic total occlusion procedure: moderator
Science Editor: Copy Editor: Production Editor: C band connections as options to right coronary artery chronic total occlusion. Vessel Plus 2019;3:21.
http://dx.doi.org/10.20517/2574-1209.2018.66
Received: 30 Sep 2018 First Decision: 4 Mar 2019 Revised: 10 Apr 2019 Accepted: 22 May 2019 Published: 13 Jun 2019

Science Editor: Alfredo R. Galassi Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract

We describe a right coronary artery (RCA) chronic total occlusion (CTO) percutaneous coronary intervention (PCI)
procedure in a very high risk patient, in whom a complex PCI with the support of Impella CP device plus Rotablator
rotational atherectomy was performed 6 months ago to revascularize a very calcified left anterior descendent. This
was an unusual approach because it was performed through a very rare connection by retrograde technique. It
was performed through a third distal septal branch connecting with the moderator band artery. Reverse controlled
antegrade and retrograde tracking technique was then successfully performed. After RCA CTO PCI, there was an
improvement in the patient symptoms and quality of life. This case highlights the important role of this unusual and
rare source of collateral circulation in RCA CTO.

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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and indicate if changes were made.

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