Antegrade Facilitated Antegrade Dissection and Re-Entry

A common challenge in percutaneous coronary interventions of chronic total occlusions (CTO) is balloon uncrossable lesions. It occurs when there is failure in crossing the lesion with a balloon or microcatheter after successfully crossing with a guidewire. This challenge is also not uncommon in non-CTO lesions with heavy calcification and tortuosity. Several techniques have been described to overcome this challenge during percutaneous coronary interventions of CTO and non-CTO lesions. We describe 2 cases illustrating the novel use of a Stingray catheter to perform antegrade dissection and re-entry in balloon uncrossable lesions.