"Tip-In" technique for retrograde chronic total occlusion revascularization

Minh N. Vo, Amir Ravandi, Emmanouil S. Brilakis

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Use of the retrograde approach significantly improves the success rate of chronic total occlusion (CTO) percutaneous coronary intervention. The most commonly applied retrograde technique is placing a guidewire just distal to the distal cap using collateral vessels, with subsequent retrograde crossing of the occlusive segment. This is followed by advancement of a microcatheter and externalization of a long guidewire to allow antegrade delivery of balloons and stents. However, there are occasions when a microcatheter or balloon cannot be delivered retrogradely through the occlusive segment, resulting in procedure failure. We describe the "tip-in" technique, which involves intubation of the retrograde guidewire with an antegrade microcatheter to allow successful revascularization of a CTO after failure to externalize.

Original languageEnglish (US)
Pages (from-to)E62-E64
JournalJournal of Invasive Cardiology
Issue number5
StatePublished - May 1 2015


  • chronic total occlusion
  • percutaneous coronary intervention
  • retrograde

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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