The standard endovascular approach to infrapopliteal artery chronic total occlusions [CTO] is the wire and catheter technique. In our paper we would like to describe a novel technique to cross these infrapopliteal artery CTOs using the Turnpike Spiral catheter. This technique involves a clockwise rotatory movement on the catheter with a very gentle forward push [70% rotation and 30% forward push]. In other words, the catheter is advanced in a forward screwing motion without a leading wire. We believe that the micro channels in these CTOs are the basis for our novel crossing technique.
Bhaskar Purushottam and Prakash Krishnan