Retrograde CTO PCI-Juniper Publishers
JUNIPER PUBLISHERS-OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Introduction The art and technique of CTO PCI have been growing at an amazing pace since past one decade. Despite many CTO specific hardware and techniques like CTO specific wires, parallel wire technique, IVUS guided side branch access, sub-intimal tracking and re-entry technique (STAR), micro-channel technique and limited antegrade sub-adventitial tracking (LAST) have been proven to be useful in antegrade approach; about 20-30% of CTOs require retrograde approach, as advocated first by Hartzler (1990) and later championed by Japanese operators (2006-2014). Retrograde approach through collateral channels (CC) is gaining acceptance to improve the success rates of CTO recanalization from 65-70% to 90-94% as distal cap is softer because it is exposed to low haemodynamic pressure shear stress from collateral flow whereas proximal cap is harder as it is exposed to high aortic pressure shea...