Department of Cardiovascular Medicine, Affiliated Nanhai Hospital, Southern Medical University (People's Hospital of Nanhai District).
The Second School of Clinical Medicine, Southern Medical University, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences.
Int Heart J. 2021 Mar 30;62(2):416-421. doi: 10.1536/ihj.20-391. Epub 2021 Mar 6.
The retrograde approach has significantly improved the success rates in complex coronary total occlusion (CTO) lesions. It has also become the predominant and important strategy in CTO recanalization. However, unsuccessful crossing of the collateral channels is the strongest predictor of retrograde failure, and adverse collateral channel morphology, including large channel entry angle, could reduce the success rate of collateral channel crossing. Reverse wire technique (RWT) was specifically developed for bifurcation lesions with an extremely angulated side branch, and nowadays, this can be achieved by the support of a dual-lumen catheter (DLC). We report a novel method named "simplified dual-lumen catheter-facilitated RWT" to facilitate markedly angulated collateral channel entry in retrograde CTO intervention. This new technique is simplified by making the reverse bend with the support of a DLC in the aorta instead of outside the guiding catheter, which is feasible, effective, and safe for markedly angulated collateral channel entry in retrograde CTO percutaneous coronary intervention (PCI).
逆行技术显著提高了复杂冠状动脉完全闭塞（CTO）病变的成功率。它也已成为 CTO 再通的主要和重要策略。然而，侧支循环未能成功通过是逆行失败的最强预测因素，而不良的侧支循环形态，包括大的通道入口角度，可能会降低侧支循环通过的成功率。反向导丝技术（RWT）专门用于具有极度成角的分支病变，如今，可以通过双腔导管（DLC）的支持来实现。我们报告了一种新的方法，名为“简化双腔导管辅助 RWT”，以促进逆行 CTO 介入治疗中明显成角的侧支循环进入。这项新技术通过在主动脉内用 DLC 形成反向弯曲来简化，而不是在导引导管外部形成反向弯曲，对于逆行 CTO 经皮冠状动脉介入治疗（PCI）中明显成角的侧支循环进入是可行、有效且安全的。
