Manual Microcatheter‐tip Modification: A bailout option for difficult “tip‐in” technique during chronic total occlusion percutaneous coronary intervention

The retrograde approach in chronic total occlusion (CTO) interventions often encounters significant challenges, particularly, when aligning the retrograde microcatheter (MC) with the antegrade system is difficult, complicating or even preventing standard externalization. To address these issues, tec...

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Bibliographic Details
Published in:Catheterization and cardiovascular interventions 2024-09, Vol.104 (3), p.507-510
Main Authors: Novotný, Vojtěch, Ungureanu, Claudiu, Král, Aleš, Varvařovský, Ivo
Format: Article
Language:English
Subjects:
Aged
Angioplasty, Balloon, Coronary - instrumentation
bailout
Cardiac Catheterization - instrumentation
Cardiac Catheters
Chronic Disease
chronic total occlusion
Coronary Angiography
Coronary Occlusion - diagnostic imaging
Coronary Occlusion - therapy
CTO
Equipment Design
Humans
Male
microcatheter
Middle Aged
Miniaturization
Occlusion
percutaneous coronary intervention
Percutaneous Coronary Intervention - instrumentation
retrograde
tip‐in
Treatment Outcome
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Summary:The retrograde approach in chronic total occlusion (CTO) interventions often encounters significant challenges, particularly, when aligning the retrograde microcatheter (MC) with the antegrade system is difficult, complicating or even preventing standard externalization. To address these issues, techniques like the “tip‐in” have proven to be effective backup strategies. We introduce the “Manual Microcatheter‐tip Modification” (MMM) technique as an alternative when the “tip‐in” method faces complications. We present a case of a left anterior descending CTO where MMM was successfully employed for the first time, enabling successful revascularization by manually modifying the MC tip to engage the retrograde guidewire. We explore the technical details within the framework of contemporary CTO PCI. This new technique could enhance the management of CTO interventions, offering innovative solutions when traditional externalization methods are problematic.
ISSN:1522-1946
1522-726X
1522-726X
DOI:10.1002/ccd.31172