{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:19:58Z","timestamp":1788268798031,"version":"build-2803163510"},"reference-count":4,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Reverse controlled antegrade and retrograde subintimal tracking (R\u2010CART) is a widely used retrograde strategy for chronic total occlusion (CTO) percutaneous coronary intervention (PCI). However, conventional R\u2010CART may fail when the antegrade wire is located within the subintimal space while the retrograde wire remains within the intraplaque space or true lumen because of anatomical layer mismatch. We describe a novel bailout technique, reverse tip detection (R\u2010TD), which applies the concept of the tip detection method to the retrograde approach under intravascular ultrasound (IVUS) guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Summary<\/jats:title>\n                    <jats:p>Two CTO PCI cases in which conventional R\u2010CART failed because of anatomical layer mismatch were successfully treated using R\u2010TD. In both cases, antegrade IVUS\u2010guided visualization of the retrograde guidewire tip enabled intentional redirection of the retrograde wire into the antegrade\u2010created subintimal space, creating a subintimal\u2010subintimal connection. This facilitated successful guidewire connection, advancement of the retrograde microcatheter, subsequent wire de\u2010escalation, and completion of CTO crossing without the need for additional dedicated re\u2010entry devices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>R\u2010TD is a feasible IVUS\u2010guided bailout strategy for R\u2010CART failure caused by anatomical layer mismatch. By enabling controlled retrograde wire redirection into the antegrade\u2010created subintimal space, R\u2010TD may simplify retrograde CTO crossing while avoiding unnecessary balloon escalation and additional dedicated devices, potentially improving procedural success and safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70732","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:03:56Z","timestamp":1783483436000},"page":"1004-1008","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reverse Tip Detection: An IVUS\u2010Guided Strategy for Retrograde Wire Crossing in CTO PCI"],"prefix":"10.1002","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5743-6742","authenticated-orcid":false,"given":"Hidenari","family":"Matsumura","sequence":"first","affiliation":[{"name":"Department of Cardiology Saiseikai Utsunomiya Hospital Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8926-9492","authenticated-orcid":false,"given":"Michiya","family":"Kageyama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nasu Red Cross Hospital Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichiro","family":"Shimoji","sequence":"additional","affiliation":[{"name":"Department of Cardiology Saiseikai Utsunomiya Hospital Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryutaro","family":"Waku","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Dokkyo Medical University and Heart Center, Dokkyo Medical University Hospital Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.70374"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.07.041"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacasi.2023.11.017"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-17-00867"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70732","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.70732","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70732","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:44:22Z","timestamp":1788266662000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.70732"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,7]]},"references-count":4,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/ccd.70732"],"URL":"https:\/\/doi.org\/10.1002\/ccd.70732","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,7]]},"assertion":[{"value":"2026-05-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}