Flashlight

DOI: 10.4244/EIJ-D-24-00895

Reverse CART facilitated by a novel perfusion balloon in chronic total occlusion percutaneous coronary intervention

Primero Ng1, MBBS (Hons); Nestor Mercado2, MD, PhD; William L. Lombardi1, MD; Lorenzo Azzalini1, MD, MSc, PhD

A 36-year-old man underwent percutaneous coronary intervention (PCI) of his right coronary artery (RCA) chronic total occlusion (CTO) due to refractory angina.

Dual angiography was performed using a 7 Fr Extra backup (EBU) 3.75 guide catheter in the left main and an 8 Fr Amplatz left (AL) 1 guide in the RCA (Figure 1A-Figure 1B, Moving image 1). The distal cap was accessed through septal collaterals using retrograde techniques (Figure 1C). The knuckle wire technique was employed to enter the extraplaque space of the CTO body using a polymer-jacketed wire.

The proximal CTO cap was engaged antegradely using a penetrative wire and microcatheter. This wire was exchanged for a polymer-jacketed wire, which was knuckled into the extraplaque space.

Reverse controlled antegrade and retrograde tracking (rCART) was then performed. The antegrade extraplaque space was predilated using a 3.0x15 mm balloon. An attempt to connect the retrograde Gladius Mongo (Asahi Intecc) wire with an antegrade 6 Fr LiquID guide extension (Seigla Medical) was unsuccessful. Subsequently, a 3.0x20 mm Ringer perfusion balloon catheter (RPBC; Teleflex), selected based on...

Sign in to read
the full article

Forgot your password?
No account yet?
Sign up for free!

Create my pcr account

Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from PCRonline.com

Volume 21 Number 3
Feb 3, 2025
Volume 21 Number 3
View full issue


Key metrics

Suggested by Cory

INTERVENTIONAL FLASHLIGHT

10.4244/EIJ-D-17-00532 Jun 20, 2018
Single guiding catheter retrograde CTO recanalisation facilitated by trapping technique: introducing the modified rendezvous technique
Konstantinidis N and Sianos G
free

10.4244/EIJV10I6A115 Oct 20, 2014
Subintimal wire pathway: part of the game of crossing chronic total coronary occlusions
Reifart N and Werner G
free

State of the art

10.4244/EIJ-D-21-01117 Sep 20, 2022
Recanalisation of coronary chronic total occlusions
Di Mario C et al
free

Research correspondence

10.4244/EIJ-D-23-00474 Dec 4, 2023
The tip-in and rendezvous techniques in retrograde chronic total occlusion percutaneous coronary interventions
Allana S et al
free

Original Research

10.4244/EIJ-D-23-01082 May 10, 2024
Controlled antegrade and retrograde subintimal tracking (CART) for recanalisation of chronic total occlusions
Moscardelli S et al
free

10.4244/EIJV11I11A241 Feb 12, 2016
Expanding options for retrograde recanalisation of right coronary artery chronic total occlusions
Brilakis E and Nicholson W
free
Trending articles
310.93

State-of-the-Art Review

10.4244/EIJ-D-21-00695 Nov 19, 2021
Transcatheter treatment for tricuspid valve disease
Praz F et al
free
166.7

Expert review

10.4244/EIJ-D-21-00690 May 15, 2022
Crush techniques for percutaneous coronary intervention of bifurcation lesions
Moroni F et al
free
92.2

State-of-the-Art Review

10.4244/EIJ-D-20-01296 Aug 27, 2021
Management of cardiogenic shock
Thiele H et al
free
76.25

State-of-the-Art

10.4244/EIJ-D-23-00840 Sep 2, 2024
Aortic regurgitation: from mechanisms to management
Baumbach A et al
free
56.65

Clinical research

10.4244/EIJ-D-20-01155 Oct 20, 2021
A deep learning algorithm for detecting acute myocardial infarction
Liu W et al
free
35

Original Research

10.4244/EIJ-D-25-00331 May 21, 2025
One-month dual antiplatelet therapy followed by prasugrel monotherapy at a reduced dose: the 4D-ACS randomised trial
Jang Y et al
open access
26

Expert Review

10.4244/EIJ-D-24-00535 May 5, 2025
Catheter-based techniques for pulmonary embolism treatment
Costa F et al
X

The Official Journal of EuroPCR and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

EuroPCR EAPCI
PCR ESC
Impact factor: 9.5
2024 Journal Citation Reports®
Science Edition (Clarivate Analytics, 2025)
Online ISSN 1969-6213 - Print ISSN 1774-024X
© 2005-2025 Europa Group - All rights reserved