Anchor wire technique improves device deliverability during PCI of CTOs and other complex subsets.
BACKGROUND
The DES era has increased the demand on PCI-based revascularization and lesion complexity. One of the technical problems still limiting success rates in complex PCI is limited device deliverability. This work describes a new technique to improve deliverability.


METHODS
When deliverability was limited during PCI, a second 0.014-inch guide wire was inserted into the non-target artery. Then, another attempt was made to deliver the device to the target lesion.


RESULTS
The technique was attempted in 13 consecutive cases with difficulties in delivering a device; five of CTO (38.5%), five of diffuse calcifications (38.5%), two of direct stenting (15.3%) and one case (7.7%) of dilated aortic root. The anchor wire technique was the only maneuver needed in eight (61.5%) cases. Additional technique was needed in four (30.7%) cases. In four out of five (80%) CTO cases, the anchor wire technique allowed successful PCI and to deliver a balloon across a CTO. Final procedural success was achieved in 12 (92.3%) cases.


CONCLUSIONS
The anchor wire technique can be very useful in increasing success rates in CTOs and various complex PCI's and has the advantage of being simple to use, without a need to re-cross the target lesion or to exchange PCI system.
Hamood
Hatem
H
Department of Cardiology, Bnai-Zion Medical Center, the Bruce Rappaport Faculty of Medicine, Technion-Israeli Institute of Technology, Haifa, Israel. hhamood65@yahoo.com
Makhoul
Nabeel
N
Grenadir
Ehud
E
Kusniec
Fabio
F
Rosenschein
Uri
U
D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000379:methods*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D011446:Prospective Studies; D015607:Stents; D016896:Treatment Outcome