The Efficacy of a Bilateral Approach for Treating Lesions With Chronic Total OcclusionsThe CART (Controlled Antegrade and Retrograde subintimal Tracking) Registry
Masashi Kimura, MD*,*,
Osamu Katoh, MD*,
Etsuo Tsuchikane, MD*,
Kenya Nasu, MD*,
Yoshihisa Kinoshita, MD*,
Mariko Ehara, MD*,
Mitsuyasu Terashima, MD*,
Hitoshi Matsuo, MD*,
Tetsuo Matsubara, MD*,
Keiko Asakura, MD*,
Yasushi Asakura, MD*,
Shigeru Nakamura, MD ,
Akitsugu Oida, MD ,
Shinichi Takase, MD,
Nicolaus Reifart, MD ,
Carlo Di Mario, MD||,
Takahiko Suzuki, MD*
* Toyohashi Heart Center, Aichi, Japan
Kyoto Katsura Hospital, Kyoto, Japan
Takase Clinic, Gunma, Japan
University of Frankfurt, Chief Department of Cardiology, Main Taunus Hospitals, Bad Soden, Germany
|| Royal Brompton Hospital and Imperial College, London, United Kingdom
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Figure 1 The Knuckle Wire Technique
The technique is used to make the subintimal space, instead of using the balloon, with the rounded tip of the wire, which resembles the "knuckle." RCA = right coronary artery.
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Figure 2 Flow Diagram of the Procedure
In 197 of 224 patients, a retrograde guidewire was successfully crossed into the target artery distal to the chronic total occlusion lesion. In 189 patients, a retrograde balloon was successfully crossed into the target artery distal to the chronic total occlusion lesion. Successful recanalization was achieved in 207 patients. Solid arrows shows "success," and dashed arrows "failure." CART = Controlled Antegrade and Retrograde subintimal Tracking.
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