Antegrade wire escalation in chronic total occlusions: State of the art review. Review uri icon

Overview

abstract

  • Coronary chronic total occlusion percutaneous coronary intervention treatment algorithms have helped to standardize crossing strategy sequence to improve efficacy and efficiency of CTO interventions based on angiographic criteria. Unfortunately, advanced crossing techniques such as a retrograde and subintimal guidewire tracking and reentry that have accelerated procedural success in more difficult lesions are associated with higher major adverse cardiac event rates as compared with traditional antegrade and intimal guidewire tracking. In this regard, antegrade wire escalation (AWE) remains the most common CTO crossing strategy. In this state of the art review, we outline the techniques employed to maximize the clinical utility of AWE crossing strategy for both novice operators as well as those experienced with the advanced crossing strategies. For the less experienced operator, these techniques may provide a framework to treat more patients safely and effectively without the need to refer to a more advanced operator. Whereas these same techniques may be employed by an advanced operator to improve the technical success in procedures requiring more advanced crossing strategies.

publication date

  • June 18, 2023

Research

keywords

  • Coronary Occlusion
  • Percutaneous Coronary Intervention

Identity

Scopus Document Identifier

  • 85162907582

Digital Object Identifier (DOI)

  • 10.1016/j.carrev.2023.06.011

PubMed ID

  • 37353443

Additional Document Info

volume

  • 55