guidewire externalization
A technique where a guidewire is passed through a chronic total occlusion and captured from another arterial access site to facilitate retrograde intervention.
Full Definition
Guidewire externalization is an advanced technique used in chronic total occlusion (CTO) interventions where a guidewire is successfully passed through the occlusion from a retrograde approach via collateral vessels and then captured and externalized through the antegrade guide catheter. This creates a continuous wire rail from the retrograde access site through the CTO to the antegrade access site, enabling delivery of balloons and stents over the externalized wire. The technique requires sophisticated wire manipulation skills and often involves the use of microcatheters to facilitate wire passage through collateral channels. Externalization allows for controlled lesion preparation and stent delivery with reduced risk of wire loss during the procedure.
Usage
Usage note: Typically used in context of CTO interventions. Specify the collateral pathway used for retrograde access.
In Context
- "Successful guidewire externalization was achieved through the RCA-to-LAD collateral, facilitating retrograde balloon angioplasty." — CTO intervention report
- "The procedure was completed using guidewire externalization technique after failed antegrade attempts." — Complex intervention case note