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Cardiovascular Intervention and Therapeutics

, Volume 33, Issue 2, pp 146–153 | Cite as

Tips of the dual-lumen microcatheter-facilitated reverse wire technique in percutaneous coronary interventions for markedly angulated bifurcated lesions

  • Tetsuya Nomura
  • Masakazu Kikai
  • Yusuke Hori
  • Kenichi Yoshioka
  • Hiroshi Kubota
  • Daisuke Miyawaki
  • Ryota Urata
  • Takeshi Sugimoto
  • Natsuya Keira
  • Tetsuya Tatsumi
Original Article
  • 288 Downloads

Abstract

In practical settings of percutaneous coronary intervention (PCI), we sometimes encounter difficulty in introducing a guidewire (GW) to the markedly angulated side branch (SB), and the reverse wire technique is considered as a last resort to overcome such a situation. We analyzed 12 cases that underwent PCI with dual-lumen microcatheter-facilitated reverse wire technique between January 2013 and July 2016. We retrospectively investigated the lesion’s characteristics and the details of the PCI procedures, and discussed tips about the use of this technique. The SB that exhibits both a smaller take-off angle and a larger carina angle is considered to be the most suitable candidate for this technique. The first step of this technique involves the delivery of the reverse wire system to the target bifurcation. However, most cases exhibit significant stenosis proximal to the bifurcation, which often hampers the delivery of the reverse wire system. Because the sharply curved reverse wire system is easier to pass the stenosis as compared to the roundly curved system, we recommend a sharp curve should be adopted for this technique. On the other hand, it is sure that device delivery is much easier on the GW with a round curve as compared to that with a sharp curve. Therefore, it is important to modify the details of this procedure on a case-by-case basis according to the lesion’s characteristics.

Keywords

Bifurcation Reverse wire technique Complex Dual-lumen microcatheter 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Statement of human rights

Written informed consents were obtained from all the study patients.

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Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2017

Authors and Affiliations

  • Tetsuya Nomura
    • 1
  • Masakazu Kikai
    • 1
  • Yusuke Hori
    • 1
  • Kenichi Yoshioka
    • 1
  • Hiroshi Kubota
    • 1
  • Daisuke Miyawaki
    • 1
  • Ryota Urata
    • 1
  • Takeshi Sugimoto
    • 1
  • Natsuya Keira
    • 1
  • Tetsuya Tatsumi
    • 1
  1. 1.Department of Cardiovascular MedicineNantan General HospitalNantanJapan

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