The tip-in and rendezvous techniques in retrograde chronic total occlusion percutaneous coronary interventions

During chronic total occlusion (CTO) percutaneous coronary intervention (PCI), retrograde wire externalisation (RWE) is the standard technique after successful retrograde guidewire crossing. When RWE is unfeasible or undesirable, the tip-in and rendezvous techniques can be used1. In the tip-in technique, the retrograde wire is advanced into an antegrade microcatheter within the antegrade guide catheter. In the rendezvous technique, an antegrade wire is advanced into the retrograde microcatheter. The system is then converted to antegrade in both scenarios. We examined the frequency and outcomes of the tip-in and rendezvous techniques in a large, multicentre registry.

We analysed the baseline characteristics and procedural outcomes of 2,456 CTO PCIs with successful retrograde crossing, performed at 44 US and non-US centres between January 2012 and March 2023 in the PROGRESS-CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention; ClinicalTrials.gov: NCT02061436) registry.

Technical success was defined as successful CTO revascularisation with <30% residual target lesion diameter stenosis and Thrombolysis in Myocardial Infarction (TIMI) grade 3 antegrade flow. Procedural success was defined as technical success without any in-hospital major adverse cardiac event...