"Move the cap" technique for ambiguous or impenetrable proximal cap of coronary total occlusion

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
Minh N VoEmmanouil S Brilakis

Abstract

Antegrade crossing remains the most commonly employed crossing strategy for coronary chronic total occlusions (CTOs) but can be challenging to perform in cases of ambiguous or impenetrable proximal cap. To successfully treat such cases, we describe a technique named "move the cap," in which the subintimal space is entered proximal to the proximal cap using a stiff coronary guidewire or facilitated by inflating a slightly oversized balloon. Subintimal guidewire entry is followed by standard antegrade dissection and re-entry. The "move the cap" technique can facilitate crossing of CTOs with ambiguous or impenetrable cap, while minimizing the risk of perforation. This technique is also useful for treating balloon uncrossable lesions. © 2015 Wiley Periodicals, Inc.

References

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Citations

Oct 30, 2016·Journal of the American College of Cardiology·Joren MaeremansJoseph Dens
Dec 10, 2016·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Aris KaratasakisEmmanouil S Brilakis
Jan 21, 2017·Current Treatment Options in Cardiovascular Medicine·Aris KaratasakisEmmanouil S Brilakis
Mar 18, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Lorenzo AzzaliniAntonio Colombo
Dec 22, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·James RoyJames C Spratt
Jul 30, 2019·Circulation·Emmanouil S BrilakisStephane Rinfret
Dec 24, 2019·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Luiz F YbarraStéphane Rinfret
Oct 24, 2018·Current Cardiology Reports·Peter TajtiEmmanouil S Brilakis
Oct 9, 2019·Expert Review of Medical Devices·Giulia IannacconeRoberto Diletti
Jul 21, 2020·Interventional Cardiology·Calum Creaney, Simon J Walsh
Nov 7, 2020·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·T BerkhoutM T Dirksen
Aug 21, 2021·Journal of the American College of Cardiology·Eugene B WuQi Zhang
Jun 2, 2021·Current Cardiology Reviews·Mohamed Farag, Mohaned Egred

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