Jan 01, 2012 Retrograde chronic total occlusion recanalization has recently become an essential complement to the classical antegrade approach. In experienced hands, the retrograde technique currently has a high success rate with a low complication profile, despite frequent utilization in the most anatomically and clinically complex patients. retrograde technique chronic total occlusion The retrograde approach is a cornerstone technique of the hybrid chronic total occlusion (CTO) percutaneous coronary intervention (CTO) portfolio. Mastering the retrograde approach substantially
Wei Liu and Kenji Wagatsuma, A novel technique of chronic total occlusion retrograde wire crossing by wiring into the antegrade microcatheter, Catheterization and Cardiovascular Interventions, 76, retrograde technique chronic total occlusion
2006. 4 Although this article exemplifies retrograde chronic total occlusion (rCTO) crossing in the coronary arteries, the physiopathological fundamentals can be extrapolated, with some reserve, to belowtheknee procedures. Briefly, the technical hurdle with antegrade guidewire passage is failure Keywords: Percutaneous coronary intervention (PCI), chronic total occlusion (CTO), drugeluting stents (DES), retrograde, antegrade dissectionreentry technique (ADR), microcatheter. BACKGROUND AND HISTORICAL PERSPECTIVE If I had an enemy I would teach him angioplasty, 1 were the words uttered by Andreas Gruentzig in Coronary chronic total occlusion represents the most challenging lesion subset for interventional cardiology. Among other new techniques and developments, the retrograde approach via collateral channels in coronary angioplasty for chronic total occlusion can retrograde technique chronic total occlusion Another retrograde technique is the rendezvous method, which uses two microcatheters moved forward in an antegrade and retrograde manner, allowing the antegrade wire to advance to the distal part of the artery. 12 Although very useful, the retrograde approach should be reserved for very experienced operators. This approach can be used after antegrade crossing failure or as the initial approach to CTO therapy, particularly in patients with ambiguous proximal caps, ostial and long occlusions General description of procedure, equipment, technique. A chronic total occlusion (CTO) is defined as the complete obstruction of a coronary artery, exhibiting TIMI 0 or TIMI 1 flow, with an occlusion duration of 3 months. The prevalence has been described as high as Chronic total occlusions are common and prognostically important. A chronic total occlusion (CTO) is usually defined as a total obstruction of a coronary artery of greater than three months duration. B. J. Friedman, A. V. Kaplan, B. D. Hettleman, et al. Retrograde techniques and the impact of operator volume on percutaneous intervention for How can the answer be improved?