Retrograde Procedural Planning, Skills Development, and How to Set Up a Base of Operations

Abstract

This article addresses the practical steps required when adopting retrograde access as part of the treatment of chronic total occlusions (CTOs). The article focuses on procedure rationale, equipment required, the practical steps, and considerations involved in collateral-channel crossing and setting up a "base of operations" at the proximal cap of the CTO. It also describes simple methods of wire escalation.

Keywords: Angiography; Chronic total occlusion; Retrograde access; Skills development.