Occlusion of left main coronary artery during percutaneous coronary intervention for chronic total occlusion of left circumflex artery with retrograde approach

2012 ◽  
Vol 28 (1) ◽  
pp. 81-86 ◽  
Author(s):  
Yasushi Ino ◽  
Yasuaki Toyoda ◽  
Shuuta Ishii ◽  
Masato Mizukoshi ◽  
Yoshio Kusuyama ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Chronic Total Occlusion ◽  
Left Main Coronary Artery ◽  
Coronary Intervention ◽  
Retrograde Approach ◽  
Left Main ◽  
Circumflex Artery ◽  
Total Occlusion ◽  
Left Circumflex Artery ◽  
Percutaneous Coronary

scholarly journals The Wire Rendezvous and Chasing Wire Technique in the Bidirectional Approach for the Percutaneous Coronary Intervention for Chronic Total Occlusion with a Single Guiding Catheter

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Keisuke Nakabayashi ◽  
Daisuke Sunaga ◽  
Nobuhito Kaneko ◽  
Akihiro Matsui ◽  
Kazuhiko Tanaka ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Circumflex Artery ◽  
Total Occlusion ◽  
Left Circumflex Artery ◽  
Rendezvous Technique ◽  
Percutaneous Coronary ◽  
The Wire ◽  
Guiding Catheter

A bidirectional approach for percutaneous coronary intervention for chronic total occlusion (CTO-PCI) using ipsilateral collaterals with a single guiding catheter limits procedural choices. The CTO of the left circumflex artery with ipsilateral collateral artery was treated by the bidirectional approach using a single guiding catheter. While the retrograde wire directly crossed the CTO lesion, the microcatheter could not pass the CTO lesion despite the conventional strategies. Therefore, we performed the wire rendezvous and chasing wire techniques. The wire rendezvous technique enables deeper retrograde guidewire progression, and the antegrade microcatheter can reach the CTO entry. The chasing wire technique enables the antegrade guidewire to pass the route made by the retrograde guidewire. These techniques might offer a possible solution for bidirectional CTO-PCI using a single guiding catheter. However, this technique should be considered as a last resort because of the risk of rapid reocclusion.

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