A Novel 3D Wiring Technique-ZOLUTION Zero Degree OverLap View Universal Three DimensIONal CTO Wiring

Area of Science:

• Cardiovascular Interventions
• Interventional Cardiology
• Medical Devices

Background:

• Coronary chronic total occlusions (CTOs) pose significant challenges in percutaneous coronary intervention (PCI).
• Traditional 3D wiring techniques can be complex and require specific imaging views, potentially limiting success rates.
• A simplified and effective 3D wiring approach is needed to improve CTO PCI outcomes.

Purpose of the Study:

• To present a novel, simple, and user-friendly 3D wiring technique for CTO PCI.
• To describe the ZOLUTION (Zero OverLap View Universal Three dimensIONal wiring) technique and its applications.
• To evaluate the potential of ZOLUTION to improve the efficiency and safety of CTO PCI.

Main Methods:

• The ZOLUTION technique involves four steps: finding a zero-degree overlap view, straightening the wire tip, moving to a secondary coaxial view, and puncturing toward the target.
• It utilizes a zero-degree overlap view (ZOV) and a secondary coaxial view (35-70 degrees) for precise wire navigation.
• The technique does not require a mental map or specific 90-degree apart fluoroscopic views.

Main Results:

• ZOLUTION simplifies 3D wiring for distal cap puncture, CTO body wiring, retrograde wiring, and reverse controlled antegrade and retrograde tracking (reverse CART).
• The technique provides a precise angle toward the target, potentially increasing success rates compared to traditional methods.
• It eliminates the need for complex mental mapping or specific angiographic views.

Conclusions:

• ZOLUTION is a simple and effective 3D wiring technique for various aspects of CTO PCI.
• Its ease of use and precision could lead to universal adoption and improved efficiency and safety in CTO interventions.
• The technique offers a promising advancement for interventional cardiologists performing CTO PCI.