title: "Seesaw balloon-wire cutting" technique is superior to Tornus catheter in balloon uncrossable chronic total occlusions.
abstract: BACKGROUND
  Inability to advance a balloon is a well-recognized cause leading to a failure in recanalization of chronic total occlusions (CTOs) despite successfully passing a guidewire. A few techniques and devices have been introduced to facilitate balloon passage, especially the use of Tornus catheter. However, complex manipulation, expensive cost, and availability limit the application of these methods. This study was to evaluate the efficiency and safety of "seesaw balloon-wire cutting" technique in comparison with Tornus catheter for balloon uncrossable CTOs.
  
  
  METHODS
  Eighty patients with balloon uncrossable CTOs were enrolled in this study. Among them, 40 patients treated with "seesaw balloon-wire cutting" technique were consecutively investigated and 40 patients treated with Tornus catheter before were matched retrospectively. A rotablator or retrograde strategy was taken as a bail-out strategy. Success rates of device and procedure and complication rate were assessed. Complications included coronary dissection, cardiac tamponade, death, Q-wave myocardial infarction (MI), non-Q-wave MI, emergency PCI and bypass surgery.
  
  
  RESULTS
  Compared with the Tornus catheter, device success rate was significantly higher with the "seesaw balloon-wire cutting" technique (87.5% vs. 45.0%, P<0.001), and the mean procedural time was much shorter (90.5±8.3min vs. 141.5±21.3min, P<0.001). The procedural success rate was also higher with the "seesaw balloon-wire cutting" technique (92.5% vs.72.5%, P=0.037). There were no differences in complication rate.
  
  
  CONCLUSIONS
  The "seesaw balloon-wire cutting" technique is superior to the Tornus catheter in treating balloon uncrossable CTOs.
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China.
authors.forename: Jingyi
authors.initials: J
authors.lastname: Xue
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China.
authors.forename: Jianqiang
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Cardiology, The First Hospital of Harbin, Harbin, China.
authors.forename: Hongjun
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China.
authors.forename: Li
authors.initials: L
authors.lastname: Sheng
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China.
authors.forename: Yongtai
authors.initials: Y
authors.lastname: Gong
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China.
authors.forename: Danghui
authors.initials: D
authors.lastname: Sun
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China.
authors.forename: Weimin
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China.
authors.forename: Dingyu
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China. Electronic address: ly99ly@vip.163.com.
authors.forename: Yue
authors.initials: Y
authors.lastname: Li
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D002908:Chronic Disease; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation*; D012189:Retrospective Studies; D016896:Treatment Outcome