Wire Escalation And De-escalation Techniques in Antegrade and Retrograde Approaches to Chronic Total Occlusion Percutaneous Coronary Interventions

Fecha de publicación: 01/01/2024

Autores de IIS La Fe

• Jorge Sanz Sánchez

  Autor

Participantes ajenos a IIS La Fe

• Novelli, Laura
• Gasparini, Gabriele

Grupos

• Grupo de Investigación Clínica y Traslacional en Cardiología

  

  Investigador Principal

  Esther Roselló Lletí

Abstract

Coronary chronic total occlusions (CTO) are frequently identified during coronary angiography and remain the most challenging subset of coronary artery lesions to treat; however, advancements in techniques and materials have greatly improved success rates. Various crossing algorithms have been developed to standardise the approach to CTO interventions based on angiographic criteria. Antegrade wiring is typically the initial strategy of choice, particularly in cases of short and straight CTOs with tapered proximal cap. Similarly, retrograde crossing can be achieved through retrograde wiring, although this approach has a very low success rate. This review aims to outline how to perform a CTO analysis, clarify the fundamental features of guidewires and provide insights into both antegrade and retrograde wire-based approaches.

Keywords

• Antegrade wiring; retrograde wiring; chronic total occlusions; percutaneous coronary intervention