A New Occluding Balloon-Facilitated Reversed Guidewire Technique in Successful Percutaneous Coronary Intervention for the Right Coronary Artery Chronic Total Occlusion Involving Distal Bifurcation

摘要

Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) can be challenging when a bifurcation lesion complicates a distal CTO cap.1,2 Baseline wiring into the true lumen at the point of bifurcation is essential to avoid jeopardizing the side branches (SB).1 The angle of bifurcation is occasionally quite large, and the reversed guidewire technique is useful in this clinical scenario.3 A critical step of the technique involves a second guidewire going into the SB far enough to provide good support. Here, we present a case where an occluding balloon technique facilitated the advance of the second guidewire.