Stéphane Rinfret MD, SM , Glen A. Henry MD , Jaikirshan J. Khatri MD , Kambis Mashayekhi MD, PhD , Khaldoon Alaswad MD , Lorenzo Azzalini MD, PhD, MSc , Luiz F. Ybarra MD, PhD, MBA , Ram Vijayaraghavan MD , Jarrod D. Frizzell MD , Alexandre Avran MD , Margaret B. McEntegart MD , William L. Lombardi MD , J. Aaron Grantham MD , Emmanouil Brilakis MD
{"title":"Knuckle Guidewires to Create Dissections in Chronic Total Occlusion Percutaneous Coronary Intervention","authors":"Stéphane Rinfret MD, SM , Glen A. Henry MD , Jaikirshan J. Khatri MD , Kambis Mashayekhi MD, PhD , Khaldoon Alaswad MD , Lorenzo Azzalini MD, PhD, MSc , Luiz F. Ybarra MD, PhD, MBA , Ram Vijayaraghavan MD , Jarrod D. Frizzell MD , Alexandre Avran MD , Margaret B. McEntegart MD , William L. Lombardi MD , J. Aaron Grantham MD , Emmanouil Brilakis MD","doi":"10.1016/j.jcin.2024.09.066","DOIUrl":null,"url":null,"abstract":"<div><div>Dissection and re-entry techniques are essential to achieve safe and effective chronic total occlusion recanalization. Several studies have demonstrated similar outcomes following extraplaque stenting compared with intraplaque stenting. Dissection techniques most often involve the use of knuckled wires to progress within and beyond the chronic total occlusion segment. In this expert consensus document, the authors compare the properties of different polymer-jacketed wires for their use in dissection techniques. The authors also describe 2 principal knuckle wire behaviors, the rolling and the traveling knuckles. Finally, several adjunctive techniques for safer dissection are described.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"17 20","pages":"Pages 2411-2424"},"PeriodicalIF":11.7000,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JACC. Cardiovascular interventions","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1936879824012810","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Dissection and re-entry techniques are essential to achieve safe and effective chronic total occlusion recanalization. Several studies have demonstrated similar outcomes following extraplaque stenting compared with intraplaque stenting. Dissection techniques most often involve the use of knuckled wires to progress within and beyond the chronic total occlusion segment. In this expert consensus document, the authors compare the properties of different polymer-jacketed wires for their use in dissection techniques. The authors also describe 2 principal knuckle wire behaviors, the rolling and the traveling knuckles. Finally, several adjunctive techniques for safer dissection are described.
期刊介绍：
JACC: Cardiovascular Interventions is a specialist journal launched by the Journal of the American College of Cardiology (JACC). It covers the entire field of interventional cardiovascular medicine, including cardiac, peripheral, and cerebrovascular interventions. The journal publishes studies that will impact the practice of interventional cardiovascular medicine, including clinical trials, experimental studies, and in-depth discussions by respected experts. To enhance visual understanding, the journal is published both in print and electronically, utilizing the latest technologies.
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