Intracoronary snaring of the retrograde guidewire: A novel method to solve compartment mismatch in complex retrograde CTO PCI.
chronic total occlusion
compartment mismatch
intracoronary snaring
intravascular ultrasound
percutaneous coronary intervention
retrograde approach
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139
Informations de publication
Date de publication:
02 2024
02 2024
Historique:
revised:
27
11
2023
received:
15
10
2023
accepted:
18
01
2024
medline:
11
2
2024
pubmed:
29
1
2024
entrez:
29
1
2024
Statut:
ppublish
Résumé
The retrograde approach has allowed a remarkable improvement in the success rate of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). After collateral channel crossing, the most crucial aspect of retrograde CTO PCI is creating the connection between the antegrade and retrograde system. Currently, the most common technique to achieve this is reverse controlled antegrade and retrograde subintimal tracking. However, this maneuver sometimes fails due to compartment mismatch (intraplaque situation of one wire and extraplaque situation of the other). New approaches are therefore needed to overcome challenges in this important step of the procedure. Here we present an innovative solution to this problem, which involved capturing the retrograde guidewire (advanced into a side branch at the distal cap) with a microsnare that had been advanced antegradely: this severed the dissection flap separating the antegrade and retrograde system, thus allowing us to successfully recanalize the CTO.
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
435-442Informations de copyright
© 2024 Wiley Periodicals LLC.
Références
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