Antegrade dissection re-entry technique for chronic total coronary occlusions

Introduction

The rationale for recanalising a chronic total coronary occlusion (CTO) is the relief of angina pectoris, the improvement of an impaired left ventricular (LV) function, and a potential favourable effect on survival 11. Galassi AR, Brilakis ES, Boukhris M, Tomasello SD, Sianos G, Karmpaliotis D, Di Mario C, Strauss BH, Rinfret S, Yamane M, Katoh O, Werner GS, Reifart N. Appropriateness of percutaneous revascularization of coronary chronic total occlusions: an overview. Eur Heart J. 2016;37:2692-700. Link. Given the beneficial effect of modern drug-eluting stents on lesion recurrence even in CTO 2, 32. Colmenarez HJ, Escaned J, Fernandez C, Lobo L, Cano S, del Angel JG, Alfonso F, Jimenez P, Banuelos C, Gonzalo N, Garcia E, Hernandez R, Macaya C. Efficacy and safety of drug-eluting stents in chronic total coronary occlusion recanalization: a systematic review and meta-analysis. J Am Coll Cardiol. 2010;55:1854-66. Link3. Gao L, Wang Y, Liu Y, Cao F, Chen Y. Long-term clinical outcomes of successful revascularization with drug-eluting stents for chronic total occlusions: A systematic review and meta-analysis. Catheter Cardiovasc Interv. 2017;89:574-581. Link, the main problem remains the successful passage of a wire through the lesion. However, the progress of interventional...