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Overview and Proposed Terminology for the Reverse Controlled Antegrade and Retrograde Tracking (reverse CART) Techniques


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Shunsuke Matsuno1; Etsuo Tsuchikane2; Scott A Harding3; Eugene B Wu4; Hsien-Li Kao5; Emmanouil S Brilakis6; Kambis Mashayekhi7; Gerald S Werner8;

1. Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan, JAPAN; 2. Toyohashi Heart Center, Toyohashi, Aichi, Japan.; 3. Department of Cardiology, Wellington Hospital, Wellington, New Zealand.; 4. Prince of Wales Hospital, Hong Kong.; 5. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.; 6. Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota and VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, Texas.; 7. Division of Cardiology and Angiology II, University Heart Center Freiburg - Bad Krozingen, Bad Krozingen, Germany; 8. Medizinische Klinik 1, Klinikum Darmstadt GmbH, Darmstadt, Germany.

During recent years, equipment and techniques for percutaneous coronary intervention (PCI) of chronic total occlusions (CTO) have significantly improved. The retrograde approach remains critical to the improved success of CTO PCI. Currently, the reverse controlled antegrade and retrograde tracking (CART) technique has become the dominant retrograde wire crossing technique. In this article, we propose a standardized terminology and classification of this technique into 3 subtypes: a) conventional reverse CART, that usually involves use of large balloons on the antegrade wire to achieve reentry within the CTO…

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