Putting it all Together: The “Hybrid” Approach

摘要: The hybrid algorithm for chronic total occlusion (CTO) percutaneous coronary intervention provides guidance on selection of the optimal CTO crossing strategy in a stepwise fashion. First, dual injection is performed. Second, four angiographic lesion characteristics are assessed—(1) proximal cap ambiguity, (2) quality distal vessel, (3) length, and (4) presence adequate collateral vessels—allowing selection. Wire escalation favored 20 mm long lesions. antegrade approach when clear, retrograde lesions with an ambiguous appropriate vessels present. Early change recommended if initially selected unsuccessful.