Revascularization of Coronary Artery Chronic Total Occlusion by Active Antegrade Reverse Wire Technique

Figure 1

Antegrade recanalization of CTO by ARW included three steps as follows: (1) after the wire accessed the branch, angiography through microcatheter was conducted to distinguish true lumen from false lumen; (2) a double cavity microcatheter and a hydrophilic-coated wire ((a) 90° shaping at 1 mm to the headend; (b) reflexed shaping at 2-3 cm to the headend) were concurrently delivered, and a small balloon could also be used to dilate the access with low pressure (avoiding changing the structures of the bifurcation) (b); and (3) withdrawal of the double cavity microcatheter, while the wire was adjusted to access the true lumen of the segment distal to the occlusion (c).

(a)

(b)

(c)