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Related Concept Videos

Bones of the Upper Limb: Radius01:09

Bones of the Upper Limb: Radius

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The radius is longer of the two bones that make up the human antebrachium or forearm. At the proximal end, the radius articulates with the capitulum of the humerus and the radial notch of the ulna to form the elbow joint. At the distal end, the radius articulates with the ulna via the ulnar notch, forming the distal radioulnar joint. Distally, the radius also attaches to the carpal wrist bones (scaphoid and lunate) to form the radiocarpal joint.
The radius has a nail-shaped head, and a...
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Related Experiment Video

Updated: Jan 10, 2026

Addressing Practical Issues in Atomic Force Microscopy-Based Micro-Indentation on Human Articular Cartilage Explants
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Proximal Cap Ambiguity.

Simon J Walsh1

  • 1Department of Cardiology, Belfast Health and Social Care Trust, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, UK.

Interventional Cardiology Clinics
|November 23, 2025
PubMed
Summary
This summary is machine-generated.

This review details safe techniques for crossing the proximal cap of chronically occluded coronary arteries. Advanced intravascular imaging and maneuvers improve procedural success for percutaneous coronary intervention.

Keywords:
Chronic total occlusionIntravascular ultrasoundProximal cap

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Biology

Background:

  • Percutaneous coronary intervention (PCI) is a common treatment for coronary artery disease.
  • Chronic total occlusions (CTO) present unique challenges during PCI, particularly at the proximal cap.
  • Angiographic visualization of the proximal cap is often insufficient for safe navigation.

Purpose of the Study:

  • To review and outline strategies for safely approaching and crossing the proximal cap of CTOs.
  • To enhance the understanding of techniques for resolving angiographic ambiguity in CTO lesions.
  • To improve the safety and efficiency of PCI for CTOs.

Main Methods:

  • Review of current literature and techniques for CTO intervention.
  • Description of supplementary intravascular imaging modalities, such as intravascular ultrasound (IVUS).
  • Explanation of advanced guidewire and catheter manipulation techniques.

Main Results:

  • Angiographic ambiguity of the proximal cap is a significant barrier in CTO PCI.
  • Intravascular imaging provides critical anatomical detail not visible on angiography.
  • Advanced techniques can successfully resolve ambiguity and facilitate cap crossing.

Conclusions:

  • Safe and effective crossing of the proximal cap is paramount for successful CTO PCI.
  • The integration of intravascular imaging and advanced techniques improves procedural outcomes.
  • These strategies are essential for interventional cardiologists managing complex CTOs.