title: "Subintimal external crush" technique for a "balloon uncrossable" chronic total occlusion.
abstract: Chronic total occlusion (CTO) revascularization is traditionally limited by the challenges related to lesion crossing. In a smaller number of cases, however, inability to advance the balloon catheter to the crossing site can account for recanalization failure ("balloon uncrossable" CTO). We describe a case of a "balloon uncrossable" CTO in which balloon crossing was achieved after subintimal dilation and "external crushing" of the CTO lesion resulting in significant modification of the CTO atheromatous plaque.
authors.affiliation: Veterans Affairs North Texas Health Care System and University of Texas Southwestern Medical School, Dallas, TX.
authors.forename: Georgios
authors.initials: G
authors.lastname: Christopoulos
authors.affiliation: Veterans Affairs North Texas Health Care System and University of Texas Southwestern Medical School, Dallas, TX.
authors.forename: Anna P
authors.initials: AP
authors.lastname: Kotsia
authors.affiliation: Veterans Affairs North Texas Health Care System and University of Texas Southwestern Medical School, Dallas, TX.
authors.forename: Bavana V
authors.initials: BV
authors.lastname: Rangan
authors.affiliation: University of Manitoba, Winnipeg, Canada.
authors.forename: Minh
authors.initials: M
authors.lastname: Vo
authors.affiliation: Henry Ford Hospital, Detroit, MI.
authors.forename: Khaldoon
authors.initials: K
authors.lastname: Alaswad
authors.affiliation: Columbia University, NY, New York.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Karmpaliotis
authors.affiliation: Veterans Affairs North Texas Health Care System and University of Texas Southwestern Medical School, Dallas, TX.
authors.forename: Subhash
authors.initials: S
authors.lastname: Banerjee
authors.affiliation: Veterans Affairs North Texas Health Care System and University of Texas Southwestern Medical School, Dallas, TX. Electronic address: esbrilakis@gmail.com.
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D062906:Cardiac Catheters; D002908:Chronic Disease; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic; D016896:Treatment Outcome
keywords: Balloon uncrossable; Chronic total occlusion; Complications; Percutaneous coronary intervention