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Manual Microcatheter-tip Modification: A bailout option for difficult "tip-in" technique during chronic total occlusion percutaneous coronary intervention

V. Novotný, C. Ungureanu, A. Král, I. Varvařovský

. 2024 ; 104 (3) : 507-510. [pub] 20240731

Language English Country United States

Document type Journal Article

Persistent link   https://www.medvik.cz/link/bmc25004126

The retrograde approach in chronic total occlusion (CTO) interventions often encounters significant challenges, particularly, when aligning the retrograde microcatheter (MC) with the antegrade system is difficult, complicating or even preventing standard externalization. To address these issues, techniques like the "tip-in" have proven to be effective backup strategies. We introduce the "Manual Microcatheter-tip Modification" (MMM) technique as an alternative when the "tip-in" method faces complications. We present a case of a left anterior descending CTO where MMM was successfully employed for the first time, enabling successful revascularization by manually modifying the MC tip to engage the retrograde guidewire. We explore the technical details within the framework of contemporary CTO PCI. This new technique could enhance the management of CTO interventions, offering innovative solutions when traditional externalization methods are problematic.

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