Retrograde dilatation of a totally occluded ostial left anterior descending artery from saphenous venous graft in the descending aorta following stenting of the aorto-ostial graft restenosis in a patient with left main coronary artery stenosis.

Treatment of native coronary and saphenous vein graft aorto-ostial stenoses with balloon angioplasty is associated with lower procedural success rates and more complications compared with percutaneous transluminal coronary angioplasty of nonostial stenoses. A patient with totally occluded ostial left anterior descending artery at ostium following aortocoronary bypass developed ostial stenosis at the saphenous vein graft in the descending aorta. The aorto-ostial lesion of saphenous vein graft was successfully stented and was followed by retrograde dilatation of the left anterior descending artery, and the totally occluded ostial lesion was reopened. The ischemia was eliminated following the procedure.