ArticleJACC. Asia2026
Real-Time Aspiration-Enabled Dual Over-the-Wire Microcatheter Enhances Parallel Wire Technique in Chronic Total Occlusion Recanalization.
Article in JACC. Asia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Rethinking the Antegrade Strategy: The Parallel Wire Technique and Tissue Environment Control.JACC. Asia · 2026Article
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11 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundSuboptimal parallel wire technique (PWT) success rates result primarily from progressive subintimal hematoma expansion during procedural maneuvers in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
objectivesThe aim of this study was to evaluate the procedural outcomes of a novel dual over-the-wire engineered, subintimal hematoma aspiration-enabled dual-lumen microcatheter (DLMC) assisted PWT in CTO PCI.
methodsOne hundred consecutive CTO PCI cases using the PWT were retrospectively analyzed, comparing outcomes between a conventional DLMC (Conv-DLMC) and a H.STARFISH (real-time [RT] aspiration DLMC) assisted PWT.
resultsReattempt cases constituted 31.0% of all procedures (31 of 100). In the RT aspiration DLMC group, 13 of 50 cases (26.0%) crossed over after Conv-DLMC failure. Hematoma aspiration was performed in 70.0% (35 of 50) of the RT aspiration DLMC group and in 100% of cases (13 of 13) switched from failed Conv-DLMC attempts. PWT success rates were significantly higher with RT aspiration DLMC (98.0% [49 of 50]; 95% CI: 89.4%-99.9%) vs Conv-DLMC (78.0% [39 of 50]; 95% CI: 64.0%-88.5%) (P < 0.001). Although median PWT duration showed no significant difference (RT aspiration DLMC vs Conv-DLMC: 22.0 minutes [Q1-Q3: 10.8-51.0 minutes] vs 23.5 minutes [Q1-Q3: 12.0-36.3 minutes]; P = 0.735), prolonged PWT attempts (>45 minutes) occurred more frequently in the RT aspiration DLMC group than the Conv-DLMC group (30.0% [15 of 50] vs 12.0% [6 of 50]; P = 0.027), with a maximum duration of 147 minutes recorded in the RT aspiration DLMC group. Meanwhile, the Conv-DLMC group required a higher rate of strategy switching to retrograde approach (4.0% [2 of 50] vs 22.0% [11 of 50]; P = 0.007). No major complications occurred in either group.
conclusionsThe RT aspiration DLMC was able to improve PWT success rates in CTO PCI and enable prolonged PWT attempts because of its RT hematoma aspiration capability.
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