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Published in: Cardiovascular Intervention and Therapeutics 1/2015

01-01-2015 | Case Report

Intravascular ultrasound-guided chronic total occlusion wiring technique using 6 Fr catheters via bilateral transradial approach

Authors: Makoto Nakashima, Yuji Ikari, Jiro Aoki, Kengo Tanabe, Shuzou Tanimoto, Kazuhiro Hara

Published in: Cardiovascular Intervention and Therapeutics | Issue 1/2015

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Abstract

A blunt stump-type entry of chronic total occlusion (CTO) is one of the most difficult morphologic features to overcome in percutaneous coronary intervention (PCI), which often requires the guidance of intravascular ultrasound (IVUS) to identify the entry point. However, real-time, IVUS-guided PCI usually requires an 8 Fr guiding catheter. In this report, we describe a successful PCI for blunt stump CTO using bi-radial, IVUS-guided CTO wiring technique. Two 6 Fr guiding catheters (one as an operating guidewire; second for IVUS imaging) were simultaneously inserted into the left coronary artery via bilateral radial arteries. This technique may be useful for CTO intervention.
Literature
1.
go back to reference Tanaka Y, Takeshita S, Takahashi S, Matsumi J, Mizuno S, Yamanaka F, et al. Comparison of short- and long-term outcomes of percutaneous coronary intervention for chronic total occlusions between patients aged ≥75 years and those aged <75 years. Am J Cardiol. 2013. doi:10.1016/j.amjcard.2013.05.005. Tanaka Y, Takeshita S, Takahashi S, Matsumi J, Mizuno S, Yamanaka F, et al. Comparison of short- and long-term outcomes of percutaneous coronary intervention for chronic total occlusions between patients aged ≥75 years and those aged <75 years. Am J Cardiol. 2013. doi:10.​1016/​j.​amjcard.​2013.​05.​005.
2.
go back to reference Morino Y, Abe M, Morimoto T, Kimura T, Hayashi Y, Muramatsu T, et al. Predicting successful guidewire crossing through chronic total occlusion of native coronary lesions within 30 minutes: the J-CTO (multicenter CTO registry in japan) score as a difficulty grading and time assessment tool. JACC Cardiovasc Interv. 2011;4:213–21.PubMedCrossRef Morino Y, Abe M, Morimoto T, Kimura T, Hayashi Y, Muramatsu T, et al. Predicting successful guidewire crossing through chronic total occlusion of native coronary lesions within 30 minutes: the J-CTO (multicenter CTO registry in japan) score as a difficulty grading and time assessment tool. JACC Cardiovasc Interv. 2011;4:213–21.PubMedCrossRef
3.
go back to reference Galassi AR, Tomasello SD, Reifart N, Werner GS, Sianos G, Bonnier H, et al. In-hospital outcomes of percutaneous coronary intervention in patients with chronic total occlusion: insights from the ERCTO (European registry of chronic total occlusion) registry. Eurointervention. 2011;7:472–9.PubMedCrossRef Galassi AR, Tomasello SD, Reifart N, Werner GS, Sianos G, Bonnier H, et al. In-hospital outcomes of percutaneous coronary intervention in patients with chronic total occlusion: insights from the ERCTO (European registry of chronic total occlusion) registry. Eurointervention. 2011;7:472–9.PubMedCrossRef
4.
go back to reference Ide S, Sumitsuji S, Kaneda H, Kassaian SE, Ostovan MA, Nanto S. A case of successful percutaneous coronary intervention for chronic total occlusion using the reversed guidewire technique. Cardiovasc Interv Ther. 2013;28(3):282–6. Ide S, Sumitsuji S, Kaneda H, Kassaian SE, Ostovan MA, Nanto S. A case of successful percutaneous coronary intervention for chronic total occlusion using the reversed guidewire technique. Cardiovasc Interv Ther. 2013;28(3):282–6.
5.
go back to reference Noguchi T, Miyazaki MS, Morii I, Daikoku S, Goto Y, Nonogi H. Percutaneous transluminal coronary angioplasty of chronic total occlusions. Determinants of primary success and long-term clinical outcome. Catheter Cardiovasc Interv. 2000;49:258–64.PubMedCrossRef Noguchi T, Miyazaki MS, Morii I, Daikoku S, Goto Y, Nonogi H. Percutaneous transluminal coronary angioplasty of chronic total occlusions. Determinants of primary success and long-term clinical outcome. Catheter Cardiovasc Interv. 2000;49:258–64.PubMedCrossRef
6.
go back to reference Park Y, Park HS, Jang GL, Lee DY, Lee H, Lee JH, et al. Intravascular ultrasound guided recanalization of stumpless chronic total occlusion. Int J Cardiol. 2011;148:174–8.PubMedCrossRef Park Y, Park HS, Jang GL, Lee DY, Lee H, Lee JH, et al. Intravascular ultrasound guided recanalization of stumpless chronic total occlusion. Int J Cardiol. 2011;148:174–8.PubMedCrossRef
7.
go back to reference Jolly SS, Yusuf S, Cairns J, Niemela K, Xavier D, Widimsky P, et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet. 2011;377:1409–20.PubMedCrossRef Jolly SS, Yusuf S, Cairns J, Niemela K, Xavier D, Widimsky P, et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet. 2011;377:1409–20.PubMedCrossRef
8.
go back to reference Yoshimachi F, Aida Y, Miura D, Kawahara R, Abe S, Suchi T. Percutaneous coronary intervention without use of guiding catheters for extreme downsizing: the emperor’s new clothes technique. Cardiovasc Interv Ther. 2013;28(2):213–5. Yoshimachi F, Aida Y, Miura D, Kawahara R, Abe S, Suchi T. Percutaneous coronary intervention without use of guiding catheters for extreme downsizing: the emperor’s new clothes technique. Cardiovasc Interv Ther. 2013;28(2):213–5.
9.
go back to reference Matsukage T, Yoshimachi F, Masutani M, Saito S, Nakazawa G, Masuda N, et al. Virtual 3 Fr PCI system for complex percutaneous coronary intervention. Eurointervention. 2009;5:515–7.PubMedCrossRef Matsukage T, Yoshimachi F, Masutani M, Saito S, Nakazawa G, Masuda N, et al. Virtual 3 Fr PCI system for complex percutaneous coronary intervention. Eurointervention. 2009;5:515–7.PubMedCrossRef
10.
go back to reference Ikari Y, Nakajima H, Iijima R, Aoki J, Tanabe K, Nakayama T, et al. Initial characterization of Ikari guide catheter for transradial coronary intervention. J Invasive Cardiol. 2004;16:65–8.PubMed Ikari Y, Nakajima H, Iijima R, Aoki J, Tanabe K, Nakayama T, et al. Initial characterization of Ikari guide catheter for transradial coronary intervention. J Invasive Cardiol. 2004;16:65–8.PubMed
11.
go back to reference Okamura A, Iwakura K, Fujii K. ViewIT improves intravascular ultrasound-guided wiring in coronary intervention of chronic total occlusion. Catheter Cardiovasc Interv. 2010;75:1062–6.PubMed Okamura A, Iwakura K, Fujii K. ViewIT improves intravascular ultrasound-guided wiring in coronary intervention of chronic total occlusion. Catheter Cardiovasc Interv. 2010;75:1062–6.PubMed
Metadata
Title
Intravascular ultrasound-guided chronic total occlusion wiring technique using 6 Fr catheters via bilateral transradial approach
Authors
Makoto Nakashima
Yuji Ikari
Jiro Aoki
Kengo Tanabe
Shuzou Tanimoto
Kazuhiro Hara
Publication date
01-01-2015
Publisher
Springer Japan
Published in
Cardiovascular Intervention and Therapeutics / Issue 1/2015
Print ISSN: 1868-4300
Electronic ISSN: 1868-4297
DOI
https://doi.org/10.1007/s12928-014-0251-y

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