Abstract
Chronic Total Occlusion (CTO) remains the most challenging lesion to treat using Percutaneous Coronary Intervention (PCI). Multiple strategies exist to facilitate lesion crossing and subsequent stenting of the target vessel. The antegrade dissection and re-entry (ADR) technique was developed to provide another option for patients to facilitate a successful CTO PCI procedure. This chapter provides a step-by-step approach to learn the technique.
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Video 6.1
Classical ADR with a stick and drive technique: More than 20 mm RCA CTO without ambiguity of the proximal cap. (AVI 3179 kb)
Video 6.2
Classical ADR with a stick and drive technique: CrossBoss into vessel structure, into the sub-intimal space at the distal cap. (AVI 3320 kb)
Video 6.3
Classical ADR with a stick and drive technique: Re-entry will have to be performed through the port pointing inferiorly. (AVI 2420 kb)
Video 6.4
Classical ADR with a stick and drive technique: Re-entry with the StingRay wire into the distal true lumen, as confirmed with a retrograde injection. (AVI 15131 kb)
Video 6.5
Classical ADR with a stick and drive technique: Final result post stenting. (AVI 2201 kb)
Video 6.6
ADR with a ‘Stick and Swap’ technique: 20 mm CTO with a non-ambiguous cap, and a good distal landing zone. (AVI 3220 kb)
Video 6.7
ADR with a ‘Stick and Swap’ technique: Sub-intimal tracking with Pilot 200 guidewire. (AVI 3960 kb)
Video 6.8
ADR with a ‘Stick and Swap’ technique: CrossBoss to distal cap. (AVI 12779 kb)
Video 6.9
ADR with a ‘Stick and Swap’ technique: StingRay in place: Stick with StingRay wire. (AVI 26344 kb)
Video 6.10
ADR with a ‘Stick and Swap’ technique: Swap with Pilot 200 into distal true lumen, as confirmed with retrograde injection. (AVI 5159 kb)
Video 6.11
ADR with a ‘Stick and Swap’ technique: Final result after stenting. (AVI 2508 kb)
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Walsh, S. (2016). When and How to Perform an Antegrade Dissection/Re-entry Approach using the CrossBoss and Stingray Catheters. In: Rinfret, S. (eds) Percutaneous Intervention for Coronary Chronic Total Occlusion. Springer, Cham. https://doi.org/10.1007/978-3-319-21563-1_6
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DOI: https://doi.org/10.1007/978-3-319-21563-1_6
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-21562-4
Online ISBN: 978-3-319-21563-1
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