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Novel ``crowbar effect'' approach to improve success rate of recanalization of coronary chronic total occlusions

Issue title: Papers from the 3rd International Conference on Biomedical Engineering and Technology (iCBEB 2014), 25–28 September 2014, Beijing, China

Subtitle:

Guest editors: Edward J. Ciaccio

Article type: Research Article

Authors: Liu, Ruifanga | Xu, Fangxinga | Liu, Tongkub; *

Affiliations: [a] Beijing Anzhen Hospital, The Capital Medical University, Beijing, China | [b] Affiliated Hospital of Beihua University, Jilin, Jilin, China

Correspondence: [*] Corresponding author: Tongku Liu, Affiliated Hospital of Beihua University, Jilin, Jilin, China. E-mail:[email protected]

Keywords: Coronary artery, chronic total occlusion, percutaneous coronary intervention, crowbar effect technique, success rate [1]

DOI: 10.3233/THC-150957

Journal: Technology and Health Care, vol. 23, no. s2, pp. S223-S230, 2015

Published: 2015
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Abstract

BACKGROUND: Coronary chronic total occlusions (CTO) are the most challenging lesions to treat percutaneously. Thus, consistent efforts are made to develop new approaches to treat CTO.

OBJECTIVE: To explore the key points of a novel ``crowbar effect'' approach to improve the success rate of recanalization of CTOs.

METHODS: One hundred and fifty-seven patients with CTO were treated with PCI using the regular antegrade guide wire approach. Of them, 36 patients (22.9%) showed that while the first guide wire was inserted into the CTO lesions, a small balloon had difficulty passing through the CTO lesions. For those patients, the new crowbar effect technique was used to allow the balloon to pass through the lesions.

RESULTS: The coronary CTO vessels in 35 patients (97.2%) were completely opened. Coronary perforation occurred in 5 patients (13.8%). This perforation was properly treated and did not lead to serious complications.

CONCLUSION: The crowbar effect technique proved successful as an alternative antegrade method for opening CTO. The procedure of this novel method is easy to accomplish and success rates are high.

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