Continuous Mechanical Suction Use During Chronic Total Occlusion Revascularization

Abstract

Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is high risk compared to non-CTO PCI. Iatrogenic coronary artery hematoma formation is a common occurrence during CTO PCI, impairing true lumen visualization. We describe the use of a continuous mechanical suction (CMS) device in 2 applications in which it was used for successful subintimal hematoma decompression and distal vessel re-entry. Additionally, we briefly review CMS utilization within the published literature. CMS use during CTO may be a viable technique in future revascularization attempts.

Keywords: Penumbra ENGINE; antegrade dissection re-entry; chronic total occlusion; continuous mechanical suction; percutaneous coronary intervention.