11. Parallel wire and IVUS guide antegrade

Parallel wire should be used when there are features suggestive of poor success rates with stingray. It is important not to get stuck in failure mode in parallel wire, if no progress is made after 15 minutes of parallel wiring, IVUS guided wiring should be used. A 1.5mm balloon should be used on one of the antegrade wire into the subintimal space to allow IVUS catheter to be delivered. It is recommended to use high penetration wire (e.g. conquest 9 or 12) for IVUS guide antegrade wiring.

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Sharma V1, Jadhav ST1, Harcombe AA1, Kelly PA2, Mozid A2, Bagnall A3, Richardson J3, Egred M3, McEntegart M4, Shaukat A4, Oldroyd K4, Vishwanathan G5, Rana O5, Talwar S5, McPherson M6, Strange JW7, Hanratty CG8, Walsh SJ8, Spratt JC6, Smith WH1. Impact of proctoring on success rates for percutaneous revascularisation of coronary chronic total occlusions. Open Heart. 2015 Mar 28;2(1):e000228.