Key result
Confluent balloon technique facilitates CTO wire crossing by creating a common subintimal space.
Why the study?
Retrograde PCI for coronary chronic total occlusions has a high success rate in experienced hands but is limited by failure of wire crossing lesions.
Does the confluent balloon technique improve the success rate of wire crossing in CTO lesions?
Does the confluent balloon technique improve the success rate of wire crossing in CTO lesions?
The confluent balloon technique offers a novel approach to facilitate wire crossing in challenging CTO interventions by creating a common subintimal space.
May support adjunctive use in select CTO cases; leaves open whether it improves crossing success versus standard techniques.
Coronary chronic total occlusions (CTO) remain one of the most challenging lesions in percutaneous coronary intervention (PCI). Retrograde approach is an advanced PCI technique and can improve success rate in CTO intervention. Although success rate of this technique is high in experienced hands, there are still limitations in this approach, e.g., failure of wire to cross lesions. We report an easy and reliable new method of wire crossing in CTO lesions. In this technique, when both the antegrade and retrograde wires are in the subintimal space, balloons catheters are delivered in both directions to the site of the CTO. The balloons are then inflated simultaneously to create a common subintimal space (the confluent of subintimal space) which will allow crossing of wire to true lumen, either antegradely or retrogradely. This technique may improve the success rate of wire crossing and successful CTO intervention.
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Zhang et al. (2011) studied Coronary chronic total occlusions (CTO). Confluent balloon technique was evaluated. The confluent balloon technique creates a common subintimal space by simultaneously inflating antegrade and retrograde balloons, potentially improving wire crossing success in CTO interventions.
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