"Subintimal external crush" technique for a "balloon uncrossable" chronic total occlusion
Related Experiment Video
Updated: Mar 17, 2026

Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
Published on: August 1, 2025
Georgios Christopoulos1, Anna P Kotsia1, Bavana V Rangan1
1Veterans Affairs North Texas Health Care System and University of Texas Southwestern Medical School, Dallas, TX.
Abstract:
Chronic total occlusion (CTO) revascularization is traditionally limited by the challenges related to lesion crossing. In a smaller number of cases, however, inability to advance the balloon catheter to the crossing site can account for recanalization failure ("balloon uncrossable" CTO). We describe a case of a "balloon uncrossable" CTO in which balloon crossing was achieved after subintimal dilation and "external crushing" of the CTO lesion resulting in significant modification of the CTO atheromatous plaque.
Related Concept Videos
Peripheral Artery Disease III: Interprofessional Care
Aneurysm III: Interprofessional Care

