title: Tips of the dual-lumen microcatheter-facilitated reverse wire technique in percutaneous coronary interventions for markedly angulated bifurcated lesions.
abstract: In practical settings of percutaneous coronary intervention (PCI), we sometimes encounter difficulty in introducing a guidewire (GW) to the markedly angulated side branch (SB), and the reverse wire technique is considered as a last resort to overcome such a situation. We analyzed 12 cases that underwent PCI with dual-lumen microcatheter-facilitated reverse wire technique between January 2013 and July 2016. We retrospectively investigated the lesion's characteristics and the details of the PCI procedures, and discussed tips about the use of this technique. The SB that exhibits both a smaller take-off angle and a larger carina angle is considered to be the most suitable candidate for this technique. The first step of this technique involves the delivery of the reverse wire system to the target bifurcation. However, most cases exhibit significant stenosis proximal to the bifurcation, which often hampers the delivery of the reverse wire system. Because the sharply curved reverse wire system is easier to pass the stenosis as compared to the roundly curved system, we recommend a sharp curve should be adopted for this technique. On the other hand, it is sure that device delivery is much easier on the GW with a round curve as compared to that with a sharp curve. Therefore, it is important to modify the details of this procedure on a case-by-case basis according to the lesion's characteristics.
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan, Kyoto, 629-0197, Japan. t2ya821@yahoo.co.jp.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Nomura
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan, Kyoto, 629-0197, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kikai
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan, Kyoto, 629-0197, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Hori
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan, Kyoto, 629-0197, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Yoshioka
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan, Kyoto, 629-0197, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kubota
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan, Kyoto, 629-0197, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Miyawaki
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan, Kyoto, 629-0197, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Urata
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan, Kyoto, 629-0197, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sugimoto
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan, Kyoto, 629-0197, Japan.
authors.forename: Natsuya
authors.initials: N
authors.lastname: Keira
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan, Kyoto, 629-0197, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tatsumi
mesh_terms: D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents
keywords: Bifurcation; Complex; Dual-lumen microcatheter; Reverse wire technique