Subintimal dissection/reentry strategies in coronary chronic total occlusion interventions.
Subintimal dissection/reentry techniques are increasingly being used for crossing coronary chronic total occlusions both antegradely (using a knucle wire or the Bridgepoint system) or retrogradely (using the controlled antegrade and retrograde tracking and dissection, and reverse controlled antegrade and retrograde tracking and dissection technique). Subintimal dissection/reentry techniques can increase procedural success rates, but their subsequent clinical outcomes are poorly studied, and they appear to be associated with high rates of in-stent restenosis and repeat target lesion revascularization. In the present review, we describe in detail the chronic total occlusions subintimal dissection/reentry techniques, clarify the related terminology and summarize the published studies in this area and the current gaps of knowledge.
VA North Texas Healthcare System and University of Texas Southwestern Medical Center, Dallas, TX 75216, USA.
Tesfaldet T
TT
Michael
Aristotelis C
AC
Papayannis
Subhash
S
Banerjee
Emmanouil S
ES
Brilakis
D062906:Cardiac Catheters; D002908:Chronic Disease; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000628:therapy*; D023903:Coronary Restenosis / Q000209:etiology; D004867:Equipment Design; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D017410:Practice Guidelines as Topic; D009626:Terminology as Topic; D016896:Treatment Outcome