Antegrade Knuckle technique assisting reverse controlled antegrade and retrograde subintimal tracking technique for caleified or tortuous chronic total occlusion recanalization
10.3969/j.issn.1004-8812.2018.06.004
- VernacularTitle:Knuckle技术辅助反向控制性正向和逆向内膜下寻径技术治疗钙化迂曲的冠状动脉慢性完全闭塞病变
- Author:
Jing-Ye LIN
1
;
Zhi-An ZHONG
;
Bin ZHANG
;
Ze-Han HUANG
;
Kai-Ze WU
;
Hong-Tao LIAO
Author Information
1. 广东省心血管病研究所心内科 广东省人民医院 广东省医学科学院
- Keywords:
Chronic total occlusion;
Percutaneous coronary intervention;
Reverse controlled antegrade and retrograde subintimal tracking
- From:
Chinese Journal of Interventional Cardiology
2018;26(6):316-319
- CountryChina
- Language:Chinese
-
Abstract:
Objective To demonstrate the efficiency and safety of the modified reverse controlled antegrade and retrograde subintimal tracking(CART)technique for chronic total occlusion(CTO)recanalization.Methods Thirteen patients with CTO underwent this modified reverse CART technique.Based on the traditional reverse CART,the technology advocated the use of antegrade guidewire Knuckle technology to promote access to the subintimal space.With the use of a strong penetrating and well controllable retrograde guidewire,balloon was inflated in the CTO lesion in favor of advancing the retrograde guidewire through the lesion to reach the proximal true lumen.Results The occlusion site was located in the RCA in 10 patients and in the LAD in 3 patients.Among the 13 lesions,2 had J-CTO score = 1,4 had J-CTO score = 2,6 had J-CTO score = 3,and 1 had J-CTO score=4.Nine cases were considered as the Werner`s Collateral Connection grade 1 and other 4 cases were grade 2.All 13 cases had achieved technical success.1 case needed pericardiocentesis due to collateral branch perforation.Conclusions CTO lesions can be efficiently and safely recanalized using this modified reverse CART technique.
