Anchor wire technique improves device deliverability during PCI of CTOs and other complex subsets

The DES era has increased the demand on PCI-based revascularization and lesion complexity. One of the technical problems still limiting success rates in complex PCI is limited device deliverability. This work describes a new technique to improve deliverability.

When deliverability was limited during PCI, a second 0.014-inch guide wire was inserted into the non-target artery. Then, another attempt was made to deliver the device to the target lesion.

The technique was attempted in 13 consecutive cases with difficulties in delivering a device; five of CTO (38.5%), five of diffuse calcifications (38.5%), two of direct stenting (15.3%) and one case (7.7%) of dilated aortic root. The anchor wire technique was the only maneuver needed in eight (61.5%) cases. Additional technique was needed in four (30.7%) cases. In four out of five (80%) CTO cases, the anchor wire technique allowed successful PCI and to deliver a balloon across a CTO. Final procedural success was achieved in 12 (92.3%) cases.

The anchor wire technique can be very useful in increasing success rates in CTOs and various complex PCI's and has the advantage of being simple to use, without a need to re-cross the target lesion or to exchange PCI system.