title: A novel guidewire approach for handling acute-angle bifurcations: reversed guidewire technique with adjunctive use of a double-lumen microcatheter.
abstract: Guidewire manipulation to negotiate branches originating at an acute angle from the parent artery is a frequently encountered challenge by the interventional cardiologist in clinical practice. To date, several methods have been developed, but none of them has a definitive success rate. Here, we report a technique for negotiating extremely angulated vascular bifurcations, with which we have achieved a high rate of success in percutaneous coronary intervention. This technique involves combining a reversed guidewire technique with a double-lumen multifunctional probing microcatheter. We present the cases of 3 patients successfully treated using this technique.
authors.affiliation: Division of Cardiovascular Medicine, Hokko Memorial Hospital, North-27, East-8, Higashi-Ku, Sapporo, Hokkaido 065-0027, Japan. jorujino.44.cardio@gmail.com
authors.forename: George
authors.initials: G
authors.lastname: Suzuki
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nozaki
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sakurai
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods*; D062906:Cardiac Catheters; D023921:Coronary Stenosis / Q000628:therapy*; D003331:Coronary Vessels / Q000033:anatomy & histology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome