E-Abstract

JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2024. Below are the accepted ones after a thorough review by our official reviewers. Don¡¯t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-028

Revolution Through 3D-Wiring: Tip Detection-Antegrade Dissection and Reentry With New Puncture Wire in Chronic Total Occlusion Intervention

By Kota Tanaka, Atsunori Okamura, Mutsumi Iwamoto, Satoshi Watanabe, Tomohiro Yamasaki, Akinori Sumiyoshi

Presenter

Kota Tanaka

Authors

Kota Tanaka1, Atsunori Okamura2, Mutsumi Iwamoto1, Satoshi Watanabe1, Tomohiro Yamasaki1, Akinori Sumiyoshi1

Affiliation

Sakurabashi Watanabe Hospital, Japan1, Sakurabashi Watanabe Advanced Healthcare Hospital, Japan2
View Study Report
TCTAP A-028
CTO

Revolution Through 3D-Wiring: Tip Detection-Antegrade Dissection and Reentry With New Puncture Wire in Chronic Total Occlusion Intervention

Kota Tanaka1, Atsunori Okamura2, Mutsumi Iwamoto1, Satoshi Watanabe1, Tomohiro Yamasaki1, Akinori Sumiyoshi1

Sakurabashi Watanabe Hospital, Japan1, Sakurabashi Watanabe Advanced Healthcare Hospital, Japan2

Background

We investigated the efficacy andfeasibility of tip detection (TD)-antegrade dissection and reentry (ADR) by comparisonof procedural outcomes with Stingray-ADR in chronic total occlusion (CTO)-percutaneouscoronary intervention (PCI).Wedevised the TD method and developed AnteOwl WR intravascularultrasound (IVUS) to standardize IVUS-based 3-dimensional wiring forintraplaque tracking in CTO-PCI. The TD method also allowed ADR (TD-ADR). CombiningTD-ADR with Conquest Pro 12 Sharpened Tip wire (CP12ST), a new ADR wire withthe strongest penetration force developed to date, enabled reentry anywhereexcept calcification sites.

Methods

Twenty-seven consecutive CTO casestreated by TD-ADR with CP12ST between August 2021 and April 2023 and 27consecutive CTO cases treated by Stingray-ADR with Conquest 8-20 wire (CP20) betweenMarch 2018 and July 2021 were retrospectively enrolled as the TD-ADR by CP12STgroup and Stingray-ADR by CP20 group, respectively, from four facilities thatcould share technical information on these procedures.

Results

The success rate of the ADR procedure wassignificantly improved (27/27 cases [100%] vs. 18/27 cases [67%], respectively;P = 0.002) and total procedural time was significantly reduced (medianprocedural time 145.0 [interquartile range: 118.0 to 240.0] min vs. 185.0 [interquartilerange: 159.5 to 248.0] min, respectively; P = 0.028) in the TD-ADR by CP12ST group compared to theStingray-ADR by CP20 group. There were few in-hospital major adverse cardiacand cerebrovascular events or no complications in either group.

Conclusion

We compared the procedural results ofStingray-ADR and TD-ADRin CTO-PCI. Compared withStingray-ADR by CP20, TD-ADR by CP12ST significantlyshortened the length of the subintimal passages, reduced the totalprocedural timeand increased the success rate of ADR with fewin-hospital major adverse cardiac and cerebrovascular events or no complications.TD-ADR by CP12ST can standardize highly accurateADR in CTO-PCI.