“Tip-In” or “Randezvouz“ techniques as a first choice in retrograde chronic total occlusion interventions.

Cardiologia Croatica

article

Mihajlo Kovačić¹  Dario Dilber.¹ 

[1] County Hospital Čakovec

关键词: percutaneous coronary intervention;    chronic total occlusion;    retrograde;    tip-in;    rendezvous;   

DOI  :  10.15836/ccar2020.49

学科分类：心脏病和心血管学

来源: Hrvatsko Kardiolosko Drustvo / Croatian Cardiac Society

【 摘 要 】

Introduction: The “Tip-In” method is a technique first described in 2015 and is developed to overcome some limitations of commonly used methods in retrograde approach in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).1,2 The most commonly applied retrograde technique is placing a guidewire just distal to the distal cap using collateral vessels, with subsequent retrograde crossing of the occlusive segment which is followed by advancement of a microcatheter and externalization of a long guidewire to allow PCI, but sometimes the microcatheter fails to advance into the antegrade guide, obstructing attempts at guidewire externalization.3 The “tip-in” technique involves the advancement of an antegrade microcatheter over the retrograde guidewire enabling subsequent antegrade wiring of the CTO segment and facilitates successful completion of a retrograde CTO procedure. Wiring can be completed by threading an antegrade wire through the retrograde microcatheter and crossing the CTO which is named rendezvous method. To our knowledge there are no published reports of a use of this technique as a primary strategy in retrograde CTO. Here we present a case where the “tip-in” technique was used not as a “bail-out” method after an unsuccessful completion of an applied retrograde technique, but as a first line strategy of retrograde approach.

【 授权许可】

Unknown