"Stick and Swap" Technique Through the ReCross Dual-Lumen Microcatheter

A major limitation of antegrade dissection and re-entry (ADR) is formation of an extraplaque hematoma that can hinder the crossing of coronary chronic total occlusions (CTOs). Use of the ReCross dual-lumen microcatheter (IMDS; Biotronik in the United States) can sometimes enable re-entry.

Here we describe a patient with angina pectoris secondary to a CTO lesion in the right coronary artery and cardiac arrest resulting from ventricular fibrillation. An Astato XS 20 wire (Asahi Intecc Medical) was advanced through both exit ports of the ReCross microcatheter, followed by successful entry into the distal true lumen with a Pilot 200 wire (Abbott Vascular).

Wiring the CTO through a ReCross dual-lumen microcatheter creates a smaller extraplaque hematoma and makes the ADR procedure easier. Other advantages are lower cost and more widespread availability.

This case highlights the importance of multimodality intervention using the ReCross catheter in the treatment of complex coronary artery obstructive disease.