Dual‐Lumen Microcatheters in Percutaneous Coronary Intervention: Five Useful Techniques to Facilitate Coronary Wiring in Non‐CTO Lesions
Asa Phichaphop, Edward Ha, Ori Waksman, Itsik Ben‐DorABSTRACT
Background
Dual‐lumen microcatheters (DLMs) are adjunctive devices that has been increasingly incorporated into contemporary percutaneous coronary intervention (PCI). These catheters contain two independent working lumens, a rapid‐exchange (RX) port and an over‐the‐wire (OTW) port, within a single low‐profile shaft, permitting guidewire advancement and exchange within a shared working space. Published consensus documents have focused predominantly on chronic total occlusion (CTO) lesions, with less on non‐CTO lesions.
Methods
This narrative review describes five practical applications of DLMs in non‐CTO lesions. For each technique, we outlined the procedural rationale, a stepwise approach, and technical considerations.
Results
Five applications are presented: (1) aorto‐ostial wiring in the setting of a protruding ostial stent or anomalous coronary takeoff; (2) reverse wiring of a side branch with an acute or angulated takeoff; (3) side‐branch re‐entry after stent deployment; (4) contrast injection through the OTW port; and (5) parallel wiring for complex lesions.
Conclusions
DLMs offer several practical applications beyond CTO PCI. Familiarity with these techniques and their technical considerations may help operators select and apply DLM‐assisted strategies in complex non‐CTO lesions.