Related Experiment Video
Updated: Jun 16, 2026
Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
Published on: May 26, 2015
The first clinical experience with a novel catheter for collateral channel tracking in retrograde approach for
Etsuo Tsuchikane1, Osamu Katoh, Masashi Kimura
1Department of Cardiology, Toyohashi Heart Center, Aichi, Japan. dokincha@aioros.ocn.ne.jp
Insights
A new channel dilator catheter shows high success in retrograde approaches for chronic total occlusion (CTO) percutaneous coronary intervention. This novel device may improve procedural efficiency and outcomes in complex CTO cases.
Area of Science:
- Interventional Cardiology
- Vascular Medicine
- Medical Device Innovation
Background:
- The retrograde approach is established for percutaneous coronary intervention of chronic total occlusions (CTOs).
- Procedural challenges persist despite established retrograde techniques for CTO.
- Novel catheter technology is needed to overcome retrograde approach limitations.
Observation:
- A novel over-the-wire channel dilator catheter was developed for CTO retrograde procedures.
- The channel dilator was utilized in 93 CTO lesions.
- Successful channel crossing and advancement into occlusion were achieved in over 94% of cases.
Findings:
- The channel dilator facilitated retrograde crossing of the entire occlusion in 84% of cases with successful retrograde wire advancement.
- Compared to historical controls, the study group using the channel dilator showed a significantly higher success rate (98.9% vs. 92.5%, p = 0.030).
- Procedure and fluoroscopy times trended lower with the novel catheter.
Implications:
- The channel dilator shows promise in simplifying and enhancing the success of the retrograde approach for CTO.
- This device may offer a valuable tool for interventional cardiologists treating complex CTO.
- Further research could validate the long-term benefits and broader applicability of this technology.
Objectives:
The aim of this study was to report the initial experience with a novel catheter in the retrograde approach for chronic total occlusion (CTO).
Background:
Although the use of the retrograde approach in percutaneous coronary intervention for CTO has been established, some procedural difficulties remain.
Methods:
A novel over-the-wire catheter (channel dilator) specifically designed for the retrograde approach has been developed for the treatment of CTO. The channel dilator was used in 93 CTO lesions after successful wiring of collateral channels using the retrograde approach.
Results:
Successful channel crossing of the catheter was achieved in 90 of the lesions (96.8%), and the channel dilator successfully advanced into the occlusion reversely during retrograde wiring in 85 lesions (94.4%). Of the 75 lesions with successful advancement of the retrograde wire into the proximal true lumen, the entire occlusion was crossed retrograde with the channel dilator in 63 lesions (84.0%). To evaluate the feasibility of the catheter, 93 CTO lesions in the preceding period were compared. Procedure and fluoroscopy time tended to be lower in the study group than in the control group. The success of the retrograde procedure was significantly higher in the study group than in the control group (98.9% vs. 92.5%, p = 0.030).
Conclusions:
The channel dilator may facilitate the conventional retrograde approach with a high level of success.
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