Antegrade approach to stumpless chronic total occlusion of ostial left anterior descending artery: first using a side branch cutting technique.

C oronary chronic total occlusions (CTO) are present in abut 15% of patients referred for percutaneous coronary intervention (PCI).1 Successful CTO-PCI is associated with improved cardiac symptoms, exercise tolerance, survival, and reduced major adverse cardiac events.2-4 Further development of new techniques has improved the success rates of CTO-PCI.5-6 Overall, the antegrade approach is still the first strategy for CTO-PCI; however, some technical challenges remain in complex CTO-PCI procedures.7-8 Here we report a successful antegrade CTO-PCI of a left anterior descending artery (LAD) with an unknown and calcified ostium, using a novel side branch cutting technique, combined with intravascular ultrasound (IVUS)-guided wiring and parallel wire techniques. Case presentation