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Knuckle technique guided by intravascular ultrasound for in-stent restenosis occlusion treatment.

Tasic M, Sreckovic MJ, Jagic N, Miloradovic V, Nikolic D - Postepy Kardiol Interwencyjnej (2015)

Bottom Line: Limited data suggest that the treatment success rate is dependent on the possibility to cross into the lumen of an occluded stent, and the decision about what technique to use varies by operator preference.The knuckle technique is used to create a deliberate dissection plane in various CTO techniques.A guide wire is pushed until a complex loop is formed and advanced through the lesion.

View Article: PubMed Central - PubMed

Affiliation: Clinical Centre Kragujevac, Kragujevac, Serbia.

ABSTRACT
One of the rarest lesions is in-stent restenosis chronic total occlusion (CTO). Limited data suggest that the treatment success rate is dependent on the possibility to cross into the lumen of an occluded stent, and the decision about what technique to use varies by operator preference. The knuckle technique is used to create a deliberate dissection plane in various CTO techniques. A guide wire is pushed until a complex loop is formed and advanced through the lesion. In this report we present a case where a knuckle wire guided by intravascular ultrasound control is used to penetrate the distal cap in an in-stent restenosis CTO lesion.

No MeSH data available.


Related in: MedlinePlus

Schematic of the knuckle wire positioning within ISR CTO lesion
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Figure 0010: Schematic of the knuckle wire positioning within ISR CTO lesion

Mentions: We have presented a technique that does not require a dedicated device for success in crossing the ISR CTO and seems relatively safe because of specific angiographic findings in ISR CTO. Figure 10 shows the positing of the knuckle within stent struts. The roadmap provided by the previously implanted stent and the ability to check the knuckle position within the stent struts, along with the added strength of the knuckled wire, should be an option when initial crossing using usual techniques has failed.


Knuckle technique guided by intravascular ultrasound for in-stent restenosis occlusion treatment.

Tasic M, Sreckovic MJ, Jagic N, Miloradovic V, Nikolic D - Postepy Kardiol Interwencyjnej (2015)

Schematic of the knuckle wire positioning within ISR CTO lesion
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4372635&req=5

Figure 0010: Schematic of the knuckle wire positioning within ISR CTO lesion
Mentions: We have presented a technique that does not require a dedicated device for success in crossing the ISR CTO and seems relatively safe because of specific angiographic findings in ISR CTO. Figure 10 shows the positing of the knuckle within stent struts. The roadmap provided by the previously implanted stent and the ability to check the knuckle position within the stent struts, along with the added strength of the knuckled wire, should be an option when initial crossing using usual techniques has failed.

Bottom Line: Limited data suggest that the treatment success rate is dependent on the possibility to cross into the lumen of an occluded stent, and the decision about what technique to use varies by operator preference.The knuckle technique is used to create a deliberate dissection plane in various CTO techniques.A guide wire is pushed until a complex loop is formed and advanced through the lesion.

View Article: PubMed Central - PubMed

Affiliation: Clinical Centre Kragujevac, Kragujevac, Serbia.

ABSTRACT
One of the rarest lesions is in-stent restenosis chronic total occlusion (CTO). Limited data suggest that the treatment success rate is dependent on the possibility to cross into the lumen of an occluded stent, and the decision about what technique to use varies by operator preference. The knuckle technique is used to create a deliberate dissection plane in various CTO techniques. A guide wire is pushed until a complex loop is formed and advanced through the lesion. In this report we present a case where a knuckle wire guided by intravascular ultrasound control is used to penetrate the distal cap in an in-stent restenosis CTO lesion.

No MeSH data available.


Related in: MedlinePlus