Coeliac artery ostial CTO angioplasty through retrograde technique

 

Introduction
Coeliac artery stenosis may present with ischemia particularly in presence of SMA stenosis.
Coeliac artery PTA/ stenting through antegrade route has been reported quite often.
There is no report of Coeliac artery PTA through retrograde technique.
We report for the first time attempted PTA of Coeliac artery ostial CTO through SMA collaterals.  
 
History and Investigations
72 yrs old male patient.  
Known hypertensive since 20 yrs. No history of diabetes/coronary artery disease. 
Recurrent severe periumbilical pain for 6 months. No association with food. No radiation. No vomiting/bowel disturbance.
The recent increase in severity and duration of pain.
Had undergone PTA /Stenting of SMA for critical stenosis of ostial SMA two months back in a different hospital. 
 
Conclusion
Retrograde angioplasty of ostial total occlusion of celiac artery attempted through collaterals from SMA. 
Balloon angioplasty with 3.5 X 15 mm balloon. 
However, wire slipped after PTA and could not be re-negotiated so the procedure was abandoned. 
The first case of retrograde PTA/ stenting of ostial coeliac artery CTO from SMA collaterals.