Limited antegrade subintimal tracking (LAST)

Limited antegrade subintimal tracking (LAST)

Brief note

Subintimal tracking is often resorted to cross chronic total occlusions (CTO). A relatively stiff wire is pushed gradually till it forms a knuckle (loop) subitimaly beyond the distal end of the lesion. After that re-entry is achieved using a wire with an acute distal bend.1 The long term results of the technique like and potential adverse outcome like restenosis and aneurysm formation are yet to be available.
Reference

  1. Michael TT et al. Subintimal dissection/reentry strategies in coronary chronic total occlusion interventions. Circ Cardiovasc Interv. 2012;5:729-38.

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