New concept for CTO recanalization using controlled antegrade and retrograde subintimal tracking: the CART technique

Area of Science:

• Interventional Cardiology
• Vascular Biology
• Medical Devices

Background:

• Percutaneous recanalization of chronic coronary occlusions (CTOs) improves patient survival and cardiac function.
• Current CTO recanalization success rates require further enhancement.
• CTO interventions remain challenging due to complex lesion characteristics.

Purpose of the Study:

• To evaluate the safety and feasibility of a novel controlled antegrade and retrograde subintimal tracking (CART) technique.
• To assess the efficacy of the CART technique in achieving successful CTO recanalization.
• To establish the CART technique as a viable option for complex CTO interventions.

Main Methods:

• The CART technique involves simultaneous antegrade and retrograde approaches for CTO recanalization.
• Subintimal dissection is carefully controlled in both antegrade and retrograde directions, limited to the CTO segment.
• A retrograde approach utilizes collateral channels from adjacent patent coronary arteries to access the occlusion.

Main Results:

• Vessel recanalization was successful in all 10 patients undergoing the CART procedure.
• The subintimal dissection was confined to the CTO region in all cases.
• No complications were observed in the collateral channels, and no in-hospital major adverse cardiac events occurred.

Conclusions:

• The CART technique is a feasible and safe approach for CTO recanalization.
• The CART technique demonstrates a high success rate in achieving vessel patency.
• This novel technique offers a promising advancement in interventional cardiology for treating complex CTOs.