Streamlined reverse wire technique for the treatment of complex bifurcated lesions.
Catheter Cardiovasc Interv
; 96(3): E287-E291, 2020 09 01.
Article
in En
| MEDLINE
| ID: mdl-31859409
ABSTRACT
Inserting a guidewire into an extremely angulated side branch (SB) is difficult. Reverse wire technique (RWT) method was developed to specifically overcome this challenging situation, and it has become common among operators performing percutaneous coronary intervention. The first step of RWT involves the delivery of a reverse wire (RW) beyond the bifurcation, together with dual lumen catheter (DLC). This step is sometimes difficult, due to the stenosis proximal to bifurcation. Balloon dilatation of the stenosis is sometimes required to make space for the RW passage, but this lesion modification involves a potential risk of vessel damage, plaque shift, or carina shift, which results in the occlusion of the target SB. Streamlined RWT is a novel method we developed to facilitate RW delivery. It consists of the following three steps:
(a) Advancing a DLC alone beyond the occlusion and inserting a preshaped RW into a non-target SB distal to the bifurcation. (b) Adjusting the position of the bending part of RW and the exit port of DLC together at the ostium of the non-target SB. (c) Advancing the RW and DLC simultaneously, while holding them both together. All procedures subsequent to the delivery of RW are the same as those required in conventional RWT. This technique enables us to deliver a RW through severe stenosis without the risk of either vessel injury or the occlusion of target SB. It also helps us to save time and effort in accomplishing SB access, even during the treatment of complex bifurcated lesions.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Coronary Artery Disease
/
Angioplasty, Balloon, Coronary
/
Coronary Stenosis
Limits:
Aged80
/
Female
/
Humans
Language:
En
Journal:
Catheter Cardiovasc Interv
Journal subject:
CARDIOLOGIA
Year:
2020
Document type:
Article
Affiliation country: