Retrograde microcatheter crossing techniques when initial approach fails

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Rapid fire Tipps and Tricks – 5 min: What do do if …retrograde microcather cannot pass the lesion Yasushi Asakura, Japan The Experts “Live” Workshop 2017 Saturday, September 16th, 2017

Santé & Médecine

If retrograde microcatheter cannot pass
the lesion,
Hakujikai Memorial Hospital
Yasushi Asakura M.D.

Standard Technique
in a Retrograde Approach
Contemporary Revers CART
Retrograde Wire into GC
Microcatheter into GC
Externalization c 300cm Wire
Hakujikai Memorial Hospital

Retrograde
Approach
Hakujikai Memorial Hospital

Reverse
CART
Hakujikai Memorial Hospital

Successful
Wiring
↓
Uncrossable
Corsair
Hakujikai Memorial Hospital

0.014”
Stainless coilPlatinum coil
Stainless wire
φ3,5,7mm
20mm 5mm
Soutenir-Microbasket
Hakujikai Memorial Hospital

BalloonBalloon
Balloon
Balloon
Hakujikai Memorial Hospital

Stent Stent
Stent
Hakujikai Memorial Hospital

Summary
1. We sometimes need snare
technique in order to catch
retrograde or antegrade wires.
2. Soutenir-Microbasket snare
is very helpful in coronary
artery.
Hakujikai Memorial Hospital

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Retrograde microcatheter crossing techniques when initial approach fails

1. If retrograde microcatheter cannot pass the lesion, Hakujikai Memorial Hospital Yasushi Asakura M.D.

2. Standard Technique in a Retrograde Approach Contemporary Revers CART Retrograde Wire into GC Microcatheter into GC Externalization c 300cm Wire Hakujikai Memorial Hospital

3. Case Hakujikai Memorial Hospital

4. Retrograde Approach Hakujikai Memorial Hospital

5. Corsair Hakujikai Memorial Hospital

6. Reverse CART Hakujikai Memorial Hospital

7. Successful Wiring ↓ Uncrossable Corsair Hakujikai Memorial Hospital

8. 0.014” Stainless coilPlatinum coil Stainless wire φ3,5,7mm 20mm 5mm Soutenir-Microbasket Hakujikai Memorial Hospital

9. Snare Hakujikai Memorial Hospital

10. Corsair Hakujikai Memorial Hospital

11. BalloonBalloon Balloon Balloon Hakujikai Memorial Hospital

12. Stent Stent Stent Hakujikai Memorial Hospital

13. Final Hakujikai Memorial Hospital

14. Summary 1. We sometimes need snare technique in order to catch retrograde or antegrade wires. 2. Soutenir-Microbasket snare is very helpful in coronary artery. Hakujikai Memorial Hospital