Chronic Total Occlusion of the Innominate Trunk: Successful Recanalization with Retrograde Technique and Dedicated Devices Borrowed from Percutaneous Coronary Interventions

Abstract

The innominate trunk is a short vessel with crucial clinical relevance as in most patients it provides flow to the right subclavian artery and the right common carotid artery. Innominate trunk occlusions are particularly challenging, as results of endovascular therapy are suboptimal in terms of acute success, whereas open surgery poses a high risk of complications. The systematic application of techniques and devices developed for coronary occlusions holds the promise of substantially improving the management of subjects with peripheral artery disease. We hereby present a case of a patient with innominate trunk occlusion who underwent successful percutaneous revascularization by carefully and expertly exploiting techniques and devices well tested in the coronary realm. This clinical vignette suggests that this treatment approach may be feasible and risk-beneficial for otherwise challenging innominate trunk occlusions.