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September 8, 2026Catheterization and Cardiovascular Interventions

Real‐Time IVUS‐Guided Wiring With a Dual‐Lumen Microcatheter for Blunt Proximal Cap CTO: Procedural Technique and Comparative Outcomes

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Authors

DKD. KimIMInki MoonMKMin Gyu Kong

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Overview

Retrospective study demonstrates reduced complex wiring and favorable procedural outcomes with real-time IVUS guidance in blunt proximal cap CTO, highlighting its utility in resolving cap ambiguity.

Key Points

  • To evaluate the feasibility, procedural techniques, and clinical outcomes of real-time intravascular ultrasound-guided wiring using a dual-lumen microcatheter for chronic total occlusions with blunt proximal caps.
  • Retrospectively analyzed 152 patients undergoing percutaneous coronary intervention for blunt-cap chronic total occlusions between January 2020 and December 2024.
  • Compared outcomes between real-time IVUS-guided wiring (n=17) using a side-branch pull-back transducer with a dual-lumen microcatheter and standard angiography-guided wiring (n=135).
  • Applied overlap weighting based on propensity scores to balance baseline characteristics, tracking adverse clinical events over 15.4 ± 6.9 months.
  • The IVUS-guided approach demonstrated reduced reliance on parallel wiring and retrograde crossing techniques compared to angiography-guided intervention.
  • High procedural success rates were achieved in both groups, alongside numerically higher rates of complete revascularization in the IVUS-guided cohort.
  • Over 15.4 ± 6.9 months of follow-up, the IVUS-guided group showed numerically fewer adverse clinical events, though the sample was underpowered for definitive statistical differences.

Cite This Study

Kim et al. (2026) studied this question.

synapsesocial.com/papers/6aa0091858e84d0ff5b47c40https://doi.org/10.1002/ccd.70847
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A comparative study of chronic total occlusion-percutaneous coronary intervention with and without intravascular ultrasound-guided wiring with respect to acute procedural outcome: A single center experience2025
  2. 2Clinical and Procedural Outcomes of IVUS-Guided vs. Angiography-Guided CTO-PCI: A Systematic Review and Meta-Analysis2023 · 22 citations
  3. 3Intravascular ultrasound guided wiring re‐entry technique for complex chronic total occlusions2018 · 17 citations
  4. 4Live IVUS-Guided Wiring in Percutaneous Coronary Intervention: A Case Report2026
  5. 5Intravascular Ultrasound Guided Percutaneous Coronary Intervention for Chronic Total Occlusion2015 · 23 citations