title: Chronic total occlusion intervention: a novel antegrade guidewire probing technique.
abstract: We reported a case of successful recanalization of a left anterior descending (LAD) artery chronic total occlusion (CTO) with 'integrate guidewire probing technique.' After we mistakenly deployed a stent at the proximal LAD from left main (LM) into a diagonal branch across the mid LAD, this mid LAD CTO became further jailed under the stent. Antegrade wiring of this CTO lesion became exceptionally difficult. After several unsuccessful attempts with different guidewires and interventional techniques, we placed a retrograde microcatheter into the CTO lesion with its tip just situated at the stent strut. An antegrade guidewire supported by another microcatheter was targeted at the tip of the retrograde microcatheter and successfully crossed the CTO lesion. The LAD was successfully recanalized. This technique appeared to be feasible and safe to facilitate antegrade wire crossing of the CTO lesion.
authors.affiliation: Division of Cardiology, Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong, People’s Republic of China. raymondfunghk@yahoo.com.hk
authors.forename: Raymond Chi-Yan
authors.initials: RC
authors.lastname: Fung
authors.forename: Chi-Kin
authors.initials: CK
authors.lastname: Chan
mesh_terms: D000328:Adult; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000379:methods*; D006328:Cardiac Catheterization; D002908:Chronic Disease; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D019233:Retreatment; D015607:Stents