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The confluent balloon technique for retrograde therapy of chronic total occlusion
1Cardiology Department, Guangdong Provincial Cardiovascular Institute, Guangdong General Hospital, Guangzhou, China. drzhangbin@yahoo.com.cn
Insights
A new technique for coronary chronic total occlusions (CTO) uses simultaneous balloon inflation to create a common subintimal space, improving wire crossing success in percutaneous coronary intervention (PCI). This method enhances CTO intervention outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Biology
Background:
- Coronary chronic total occlusions (CTO) present significant challenges in percutaneous coronary intervention (PCI).
- The retrograde approach is an advanced PCI technique that can improve success rates in CTO interventions.
- Limitations exist, including wire crossing failure, even with experienced operators.
Abstract:
Coronary chronic total occlusions (CTO) remain one of the most challenging lesions in percutaneous coronary intervention (PCI). Retrograde approach is an advanced PCI technique and can improve success rate in CTO intervention. Although success rate of this technique is high in experienced hands, there are still limitations in this approach, e.g., failure of wire to cross lesions. We report an easy and reliable new method of wire crossing in CTO lesions. In this technique, when both the antegrade and retrograde wires are in the subintimal space, balloons catheters are delivered in both directions to the site of the CTO. The balloons are then inflated simultaneously to create a common subintimal space (the confluent of subintimal space) which will allow crossing of wire to true lumen, either antegradely or retrogradely. This technique may improve the success rate of wire crossing and successful CTO intervention.
