Simultaneous cannulation: a technique for percutaneous transluminal coronary angioplasty of chronic total occlusions.

Three patients with indications for percutaneous transluminal angioplasty of a totally occluded coronary artery also had distal opacification by a collateral vessel. The balloon catheter and guide wire were manipulated proximally through the guide catheter. With a second catheter, angiography of the collateral vessel opacified the occluded artery distal to the obstruction. In all three cases, simultaneous catheterization was safe and aided our assessment of distal vessel contour, length of occlusion, and the intraluminal position of the wire beyond the complete obstruction. We conclude that this technique may improve success rates for dilating chronic total obstructions by allowing safer manipulation of less flexible wires.