Philosophy of Directed reverse CART
In this video we demonstrated the theory behind end balloon wiring (EBW).
In traditional reverse CART, we overlap antegrade and retrograde wires and inflate the antegrade balloon and try to puncture into the antegrade balloon space from the side of the balloon (side balloon entry technique). However, sometimes the wire would slip up parallel to the balloon instead of puncturing in. Even if we puncture into the antegrade balloon space, the wire may cross the space and re-enter the subintimal space through and through the lumen.
Wires are forward moving devices and they exert the best penetration force to targets that are immediately in front of the wire. Therefore, if we aim the wire to forwards the end of the balloon, as the final part of this video, we can easily achieve successful reverse CART.
This is End Balloon Wiring (EBW).
Step by Step externalisation demonstration
Fat embolism to stop perforation