Hamidani Fadhel Nabil, Brilakis Emmanouil S, Berisha Blerim
Cardiology Department, Neuendettelsau Clinic, Neuendettelsau, Germany.
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA.
JACC Case Rep. 2025 May 28;30(12):103371. doi: 10.1016/j.jaccas.2025.103371. Epub 2025 Apr 23.
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.
TAKE-HOME MESSAGE: This case highlights the importance of multimodality intervention using the ReCross catheter in the treatment of complex coronary artery obstructive disease.
顺行内膜下血管成形术及重回真腔技术（ADR）的一个主要局限性是形成斑块外血肿，这可能会阻碍冠状动脉慢性完全闭塞病变（CTO）的通过。使用ReCross双腔微导管（美国的IMDS；百多力公司）有时可实现重回真腔。
在此，我们描述一名继发于右冠状动脉CTO病变的心绞痛患者，其因室颤导致心脏骤停。一根AstaTo XS 20导丝（旭化成医疗）通过ReCross微导管的两个出口推进，随后使用一根Pilot 200导丝（雅培血管）成功进入远端真腔。
通过ReCross双腔微导管对CTO进行导丝操作会产生较小的斑块外血肿，使ADR操作更容易。其他优点是成本较低且可用性更广泛。
本病例强调了在复杂冠状动脉阻塞性疾病治疗中使用ReCross导管进行多模态干预的重要性。
