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Updated: May 19, 2026
Complete and Partial Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock
Published on: May 19, 2022
New re-entry device for revascularization of chronic coronary total occlusions: preliminary single Japanese center
Etsuo Tsuchikane1, Masashi Kimura, Takahiko Suzuki
1Department of Cardiology, Toyohashi Heart Center, 21-1 Gobudori, Oyama, Toyohashi, Aichi, 441-8530, Japan. dokincha@aioros.ocn.ne.jp
Background:
Although retrograde approach for coronary chronic total occlusion (CTO) has been introduced, the procedure is still time and resource consuming. A simplified antegrade approach mightbe another resort. The aim of this study was to evaluate a new device designed to facilitate guidewire re-entry into the true lumen of a CTO from the adjacent subintimal space.
Methods:
Patients with CTO were entered into a prospective registry regardless of lesion characteristics. A new metal-tip catheter was used initially in primary use cases. If it created subintimal tracking, a new re-entry tool (a flat balloon with 2 exit ports offset by 180 degrees) was used as a platform to attempt guidewire penetration into the distal true lumen. In rescue use cases after unsuccessful conventional wiring, the re-entry procedure was subsequently attempted.
Results:
In 11 CTO lesions attempted, device success was achieved in 8 cases (72.7%). Re-entry procedure success rate was higher in primary use cases (80%) compared to rescue use cases (33.3%). Retrograde approach was conducted immediately after unsuccessful antegrade procedure using this device in the other 3 cases and successful recanalization was achieved in all cases. All lesions were stented, resulting in TIMI 3 flow without major complications.
Conclusion:
A new coronary re-entry device may provide another strategic option in the antegrade approach to recanalize CTOs.
