Intravascular lithotripsy-facilitated balloon-assisted subintimal entry for chronic total occlusion percutaneous coronary intervention.

Abstract

Severely calcified chronic total occlusions (CTO) are particularly challenging to recanalize with a conventional wiring approach. Balloon-assisted subintimal entry (BASE) is an effective option to get access to the extraplaque space and set up for antegrade dissection/re-entry. However, conventional balloons are sometimes unable to dissect the vessel due to severe calcification, and alternative solutions are warranted. In this article, we report, for the first time, on the use of intravascular lithotripsy (IVL) to facilitate BASE in the context of CTO percutaneous coronary intervention.