The “side‐BASE technique”: Combined side branch anchor balloon and balloon assisted sub‐intimal entry to resolve ambiguous proximal cap chronic total occlusions

Roy, James; Hill, Jonathan; Spratt, James C.

doi:10.1002/ccd.27422

Cited by 25 publications

(14 citation statements)

References 5 publications

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“…When a side-branch is present at the proximal cap, a modification of this technique (side-BASE) can be used. 25 A blocking balloon is positioned in the side-branch causing deflection of the knuckle wire into a dissection plane ( Figure 5).…”

Section: Impenetrable Proximal Capmentioning

confidence: 99%

Antegrade Chronic Total Occlusion Strategies: A Technical Focus for 2020

Creaney

Walsh

2020

Interv Cardiol

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Chronic total occlusions (CTOs) are common in patients with ischaemic heart disease. In many countries, patients with CTOs are underserved by percutaneous coronary intervention (PCI). One of the barriers to CTO PCI is the technical challenges of these procedures. Improvements in technique and dedicated devices for CTO PCI, combined with advances in procedural strategy, have resulted in a dramatic increase in procedural success and outcomes. Antegrade wiring (AW) is the preferred initial strategy in short CTOs, where the proximal cap and course of the vessel is understood. For many longer, more complex occlusions, AW has a low probability of success. Dissection and re-entry techniques allow longer CTOs and those with ambiguous anatomy to be crossed safely and efficiently, and CTO operators must also be familiar with these strategies. The CrossBoss and Stingray system is currently the primary targeted re-entry device used during antegrade dissection and re-entry (ADR), and there continues to be an evolution in its use to increase procedural efficiency. In contrast to older ADR techniques, targeted re-entry allows preservation of important side-branches, and there is no difference in outcomes compared to intraplaque stenting.

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Section: Impenetrable Proximal Capmentioning

confidence: 99%

Antegrade Chronic Total Occlusion Strategies: A Technical Focus for 2020

Creaney

Walsh

2020

Interv Cardiol

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“…A modification of this technique is the side-BASE [16], which can be useful when dealing with a blunt, ambiguous cap of the CTO body with a side branch next to the cap. A balloon is inflated in the side branch, and this redirects the guidewire to the cap.…”

Section: Making a Dissection And Entering The Sismentioning

confidence: 99%

Advances in percutaneous coronary intervention for chronic total occlusions: current antegrade dissection and reentry techniques and updated algorithm

Claessen

Dirksen

2020

Neth Heart J

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Percutaneous coronary intervention (PCI) for chronic total occlusions (CTO) is considered relatively complex with low success rates and high complication rates. Treating a CTO with PCI using the hybrid algorithm increases success rates with acceptable complication rates. An essential part of the hybrid algorithm is antegrade dissection and reentry (ADR). In PCI of a non-CTO coronary lesion, the guidewire over which the stent is advanced and placed stays within the true lumen of the coronary artery. ADR techniques make it possible to cross the lesion through the wall of the coronary artery, the subintimal space, thus creating a small bypass within the architecture of the coronary artery and restoring antegrade blood flow. ADR increases success rates, especially in more difficult CTO procedures. In the last decade, new materials and techniques have been introduced in quick succession, which are summarised in this review. Consequently an updated ADR algorithm is presented, which can support the CTO operator during an ADR procedure.

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“…After that, a second balloon is partially inflated into the side branch in order to deflect and anchor the wire to the microcatheter, so that the wire can be pushed beyond the inflated balloon and pass the proximal cap, usually within the subintimal space. As described for the BASE technique, the procedure could be concluded with anterior dissection and reentry technique [75].…”

Section: Antegrade Approachmentioning

confidence: 99%

Current approaches for treatment of coronary chronic occlusions

Iannaccone

Scarparo

Wilschut

et al. 2019

Expert Review of Medical Devices

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Introduction: Coronary chronic total occlusions (CTO) represent a challenging subset in interventional cardiology. Areas covered: During the last decade, improvements in materials, techniques, and meticulous preprocedural lesion assessment have increased the success rate in CTO lesions. Several scores have been developed to address overall lesion evaluation and help select the most appropriate treatment strategy. In addition, specific algorithms such as the hybrid algorithm have been introduced to provide a framework for CTO operators and a rapid management of the various challenging aspects of the procedure. The hybrid approach requires operator's ability to switch from one treatment strategy to another when the first one appears to be unsuccessful. Adequate training and operators' experience remain crucial to improve the likelihood of success. Expert opinion: The aim of this review is to provide insights and guidance for operators on current approaches for treatment of CTO and complication management.

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The “side‐BASE technique”: Combined side branch anchor balloon and balloon assisted sub‐intimal entry to resolve ambiguous proximal cap chronic total occlusions

Cited by 25 publications

References 5 publications

Antegrade Chronic Total Occlusion Strategies: A Technical Focus for 2020

Antegrade Chronic Total Occlusion Strategies: A Technical Focus for 2020

Advances in percutaneous coronary intervention for chronic total occlusions: current antegrade dissection and reentry techniques and updated algorithm

Current approaches for treatment of coronary chronic occlusions

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