Overview and proposed terminology for the reverse controlled antegrade and retrograde tracking (reverse CART) techniques

Shunsuke Matsuno, Etsuo Tsuchikane, Scott A. Harding, Eugene B. Wu, Hsien Li Kao, Emmanouil S. Brilakis, Kambis Mashayekhi, Gerald S. Werner

Research output: Contribution to journalReview articlepeer-review

26 Scopus citations


During recent years, equipment and techniques for percutaneous coronary intervention (PCI) of chronic total occlusions (CTO) have improved significantly. The retrograde approach remains critical to the improved success of CTO PCI. Currently, the reverse controlled antegrade and retrograde tracking (CART) technique has become the dominant retrograde wire crossing technique. In this article, we propose a standardised terminology and classification for this technique divided into three subtypes: A) conventional reverse CART, usually involving the use of large balloons on the antegrade wire to achieve re-entry within the CTO segment; b) "directed" reverse CART, which is characterised by small antegrade balloon size and more active, intentional vessel tracking and penetration with a controllable retrograde wire, still within the CTO segment; and c) "extended" reverse CART, in which the intimal/subintimal dissection is extended proximal or distal to the CTO segment, achieving re-entry outside the CTO segment. The proposed standardised terminology will facilitate the communication, teaching and adoption of the reverse CART techniques.

Original languageEnglish (US)
Pages (from-to)94-101
Number of pages8
Issue number1
StatePublished - May 2018


  • Chronic coronary total occlusion
  • Other technique
  • Stable angina

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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