Coronary CTO Re-Entry System
The Hybrid Approach to Treating CTOs
The Algorithm Emphasizes:
- Procedural efficiency and minimizing the amount of radiation and contrast
- Quick transition to alternate plans when failure mode occurs; always make progress — don’t let the case stall
1 Hybrid Strategies for Retrograde and Antegrade Lesion Crossing Based on Anatomy, the Hybrid Registry. Talk presented at the Chronic Total Occlusion and Left Main Summit; February 21-23, 2013; New York, NY.
Putting it All Together
- Proximal cap clear or ambiguous by angio +/- IVUS
- Quality of distal target
- Lesion length < or ≥ 20 mm
- Suitability of “interventional” collaterals
2 Brilakis ES, Grantham JA, Rinfret S, Wyman M, Burke MN, Karmpaliotis D, et al. A percutaneous treatment algorithm for crossing coronary chronic total occlusions. J Am Coll Cardiol Intv. 2012;5(4):367-379. doi:10.1016/j.jcin.2012.02.006.