Ping-Pong Guide Catheters to Facilitate Real-Time Intravascular Ultrasound-Guided Recanalization of Stumpless Chronic Total Occlusion

Ching-Tang Chang; Wen-Hsien Lee; Hsuan-Fu Kuo; Mark Z Chen; Po-Chao Hsu; Chih-Sheng Chu; Ho-Ming Su; Tsung-Hsien Lin; Hsueh-Wei Yen; Cheng-An Chiu

doi:10.1016/j.jaccas.2019.11.005

Ping-Pong Guide Catheters to Facilitate Real-Time Intravascular Ultrasound-Guided Recanalization of Stumpless Chronic Total Occlusion

JACC Case Rep. 2019 Dec 18;1(5):792-795. doi: 10.1016/j.jaccas.2019.11.005.

Authors

Ching-Tang Chang^{1

2}, Wen-Hsien Lee¹, Hsuan-Fu Kuo^{1

2}, Mark Z Chen³, Po-Chao Hsu¹, Chih-Sheng Chu^{1

2}, Ho-Ming Su^{1

4}, Tsung-Hsien Lin^{1

4}, Hsueh-Wei Yen¹, Cheng-An Chiu¹

Affiliations

¹ Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
² Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
³ Department of Translational Immunology, Genentech, South San Francisco, California.
⁴ Department of Internal Medicine, Faculty of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Abstract

Stumpless chronic total occlusion is associated with a higher failure rate of recanalization. Intravascular ultrasound (IVUS) is useful for identifying the entry point; however, 8-F guide catheters are necessary for real-time IVUS-guided wiring. This case reports the novel use of the "ping-pong" guide catheter technique to facilitate real-time IVUS-guided wiring for a stumpless chronic total occlusion. (Level of Difficulty: Advanced.).

Keywords: CTO, chronic total occlusion; IVUS, intravascular ultrasound; LAD, left anterior descending artery; PCI, percutaneous coronary intervention; complex and high-risk coronary intervention; coronary artery disease; percutaneous coronary intervention.

Publication types

Case Reports