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| http://dx.doi.org/10.1016/j.jcin.2021.02.012 | DOI Listing |
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Minimalistic chronic total occlusion treatments using tip detection-antegrade dissection and re-entry: a case series.
Eur Heart J Case Rep
August 2025
Department of Cardiology, Sapporo Cardio Vascular Clinic, 8-1, North 49-East 16, Higashi ward, Sapporo, Hokkaido 007-0849, Japan.
Background: Since chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is mainly aimed at symptom relief, it should avoid placing patients at risk. Tip detection-antegrade dissection and re-entry (TD-ADR), whose wiring time has been reported to be shorter compared to retrograde approach, do not need a dual access. Although the retrograde approach is effective, it is a significant risk factor for in-hospital adverse events after CTO PCI.
View Article and Find Full Text PDFProcedural Impact of Advanced Calcific Plaque Modification Devices Within Percutaneous Revascularization of Chronic Total Occlusions.
JACC Cardiovasc Interv
June 2025
Division of Cardiology, University Hospital "P. Giaccone," Palermo, Italy; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy. Electronic address:
Background: Significant calcifications within a coronary chronic total occlusion (CTO) increase procedural complexity and the risk for complications. Expert consensus documents recommend the use of advanced calcific plaque modification devices (ACPMDs) for calcified CTO percutaneous coronary intervention (PCI), whereas data on their procedural impact are limited.
Objectives: The aim of this study was to describe trends, settings, and outcomes of PCI of severely calcified CTO performed with and without ACPMDs.
"Stick and Swap" Technique Through the ReCross Dual-Lumen Microcatheter.
JACC Case Rep
May 2025
Cardiology Department, Neuendettelsau Clinic, Neuendettelsau, Germany. Electronic address:
Background: 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.
Case Summary: 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.
Snare-Assisted LAceration of Subintimal Hematoma (SLASH): A Novel Technique for Side Branch Preservation in Bifurcation Chronic Total Occlusion Percutaneous Coronary Intervention.
Catheter Cardiovasc Interv
August 2025
Department of Medicine, Division of Cardiology, University of Washington, Seattle, Washington, USA.
Background: Side branch compromise due to extraplaque hematoma often complicates chronic total occlusion (CTO) percutaneous coronary intervention (PCI) involving a bifurcation at the distal cap.
Aims: To evaluate the feasibility and short-term outcomes of Snare-Assisted LAceration of Subintimal Hematoma (SLASH), a novel technique designed to mitigate this problem.
Methods: SLASH involves retrograde true lumen wiring across the distal bifurcation into a distal side branch, followed by successful antegrade dissection/re-entry into the same branch.
Use of ReCross to Increase Success Rate With Antegrade CTO PCI-A Multicenter Observational Study.
Catheter Cardiovasc Interv
July 2025
Valenciennes Hospital, Valenciennes, France.
Background: Antegrade approach remains one of the predominant techniques for CTO PCI. Success rates have increased significantly recently due to advancements in devices and strategies, along with the hybrid algorithm. ReCross is a uniquely modified microcatheter with two over-the-wire lumens and three exit ports, offering significant potential for application across all facets of antegrade CTO-PCI applications.
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