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"Ping-pong" guide catheter technique for retrograde intervention of a chronic total occlusion through an ipsilateral

Emmanouil S Brilakis1, J Aaron Grantham, Subhash Banerjee

  • 1VA North Texas Healthcare System, University of Texas Southwestern Medical Center at Dallas, USA. esbrilakis@yahoo.com

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|November 10, 2010
PubMed

Insights

This study introduces a new "ping-pong" technique for retrograde interventions on coronary chronic total occlusions. It uses two guiding catheters to successfully cross lesions and deliver equipment via an ipsilateral collateral artery.

Area of Science:

  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Coronary chronic total occlusions (CTOs) present significant challenges for percutaneous coronary intervention.
  • Existing retrograde techniques may have limitations in complex CTO anatomies.

Observation:

  • A novel technique utilizing two guiding catheters for retrograde CTO intervention via an ipsilateral collateral is described.
  • The technique involves alternating engagement of the target coronary artery between antegrade and retrograde guiding catheters, termed "ping-pong" fashion.

Findings:

  • This "ping-pong" approach facilitates guidewire advancement and externalization.
  • It enables effective lesion crossing and equipment delivery in challenging CTO cases.

Implications:

  • This technique offers a potential new strategy for treating complex coronary chronic total occlusions.
  • It may improve procedural success rates and expand treatment options for patients with CTOs.

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