Abstract
Use of the retrograde approach significantly improves the success rate of chronic total occlusion (CTO) percutaneous coronary intervention. The most commonly applied retrograde technique is placing a guidewire just distal to the distal cap using collateral vessels, with subsequent retrograde crossing of the occlusive segment. This is followed by advancement of a microcatheter and externalization of a long guidewire to allow antegrade delivery of balloons and stents. However, there are occasions when a microcatheter or balloon cannot be delivered retrogradely through the occlusive segment, resulting in procedure failure. We describe the "tip-in" technique, which involves intubation of the retrograde guidewire with an antegrade microcatheter to allow successful revascularization of a CTO after failure to externalize.
Original language | English (US) |
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Pages (from-to) | E62-E64 |
Journal | Journal of Invasive Cardiology |
Volume | 27 |
Issue number | 5 |
State | Published - May 1 2015 |
Keywords
- chronic total occlusion
- percutaneous coronary intervention
- retrograde
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine