Recanalization of difficult bifurcation lesions using adjunctive double-lumen microcatheter support: two case reports.

BACKGROUND: The success rates of percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs) have improved with advances in devices, equipment and expertise, including the use of the retrograde approach. CTO with bifurcation lesions is a special overlapping subset of CTO and bifurcated coronary artery disease (CAD) management. PCI for bifurcated CAD is associated with higher restenosis rates and procedural complications, so the optimal management strategy remains the focus of intense research and debate. A specially designed double-lumen microcatheter can be used for difficult bifurcation lesion recanalization, and to save time and devices. This report presents 2 cases of CTOs with bifurcation lesions that were successfully treated with adjunctive double-lumen microcatheters to achieve vessel preservation. This technique is simple and reliable, and warrants more clinical practice for validation.