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Intravascular lithotripsy assisted chronic total occlusion revascularization with reverse controlled antegrade retrograde tracking
Author(s) -
Yeoh Julian,
Hill Jonathan,
Spratt James C.
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28165
Subject(s) - medicine , conventional pci , percutaneous coronary intervention , occlusion , revascularization , stent , calcification , coronary occlusion , lithotripsy , cardiology , radiology , surgery , myocardial infarction
Advances in percutaneous coronary intervention (PCI) techniques in chronic total occlusion (CTO) procedures have improved the success of this procedure. CTO PCI via the retrograde approach are facilitated most frequently by reverse controlled antegrade/retrograde tracking (R‐CART). This aims to create a communication between the proximal and distal lumens, which may be achieved between intimal and subintimal spaces. In patients with calcified coronary vessels, creating sufficient disruptions to connect these spaces can be challenging. Intravascular lithotripsy (IVL) has become a useful tool to modify intracoronary calcification for stent deployment and expansion. This case demonstrates the utility of IVL in facilitating connection in R‐CART to complete the CTO PCI where heavy calcification was present at the site of chronic occlusion.