Anchor wire technique improves device deliverability during PCI of CTOs and other complex subsets

Abstract

Introduction: The DES era has increased the demand on PCI‐based revascularization and lesion complexity. One of the technical problems still limiting success rates in complex PCI is limited device deliverability. This work describes a new technique to improve deliverability.

Methods: When deliverability was limited during PCI, a second 0.014‐inch guide wire was inserted into the non‐target artery. Then, another attempt was made to deliver the device to the target lesion.

Results: The technique was attempted in 13 consecutive cases with difficulties in delivering a device; five of CTO (38.5%), five of diffuse calcifications (38.5%), two of direct stenting (15.3%) and one case (7.7%) of dilated aortic root. The anchor wire technique was the only maneuver needed in eight (61.5%) cases. Additional technique was needed in four (30.7%) cases. In four out of five (80%) CTO cases, the anchor wire technique allowed successful PCI and to deliver a balloon across a CTO. Final procedural success was achieved in 12 (92.3%) cases.

Conclusions: The anchor wire technique can be very useful in increasing success rates in CTOs and various complex PCI's and has the advantage of being simple to use, without a need to re‐cross the target lesion or to exchange PCI system.

• Balloon
• stent
• chronic total occlusion (CTO)
• percutaneous coronary interventions
• calcification
• wire