“Power knuckle” for facilitating the “move the cap” technique

Minh N. Vo, Emmanouil S. Brilakis, William Lombardi

Research output: Contribution to journalArticlepeer-review


Chronic total occlusions with proximal cap ambiguity remains the most challenging to recanalize and are associated with higher failure rate. We describe the “power knuckle” technique, in which the subintimal space proximal to the proximal cap is safely entered with a knuckle wire supported by a microcatheter and an inflated balloon. The “power knuckle” can facilitate entry into the extraplaque space for subsequent antegrade dissection and re-entry.

Original languageEnglish (US)
JournalCatheterization and Cardiovascular Interventions
StateAccepted/In press - 2023


  • chronic total occlusion
  • percutaneous coronary intervention

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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