{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:49:36Z","timestamp":1785851376409,"version":"3.56.0"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We aimed to evaluate the efficacy and safety of the combination of the Slipstream technique and the tip detection\u2010antegrade dissection and re\u2010entry (TD\u2010ADR) technique in the treatment of complex CTO lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty\u2010seven consecutive patients with long CTO lesion (&gt;20\u2009mm) between June 2024 and March 2025 were enrolled. The main steps of the procedure included: (1) for a CTO characterized by an ambiguous proximal cap and the presence of an applicable side branch originating proximal to the occlusion, the Slipstream technique was used to identify the precise entry point of the CTO lesion and guide the puncture into the CTO proximal cap. (2) Once the stiff guidewire went into the subintimal space during the advancement, IVUS was advanced along the guidewire to confirm the entry point of the subintimal space. (3) Advanced a dual\u2010lumen microcatheter over the same guidewire and introduced another stiffer wire via the second wire port to puncture the entry point, and tried to re\u2010enter the true lumen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In this study, 17 (36.2%) cases were stumpless, and the left anterior descending artery (LAD) was the most frequent CTO target vessel (55.3%). The entry point into the subintimal space was identified by IVUS in all 47 cases, the combination of the Slipstream and TD\u2010ADR techniques was succeeded in 42 cases. Fourty five CTO cases were finally successfully recanalized (95.7%) with no serious procedure\u2010related complication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The combination of the Slipstream and the TD\u2010ADR techniques is feasible and safe for the recanalization of complex CTO lesions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70744","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:16:46Z","timestamp":1785849406000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Combination of the Slipstream and the TD\u2010ADR Techniques: An Effective and Safe Strategy for Precision Recanalization of Complex Chronic Total Occlusions"],"prefix":"10.1002","author":[{"given":"Yuan","family":"Fu","sequence":"first","affiliation":[{"name":"Heart Center, Beijing Chaoyang Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Heart Center, Beijing Chaoyang Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuang","family":"Li","sequence":"additional","affiliation":[{"name":"Heart Center, Beijing Chaoyang Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Heart Center, Beijing Chaoyang Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4399-6218","authenticated-orcid":false,"given":"Lin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Heart Center, Beijing Chaoyang Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"issue":"2","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.ijcard.2009.10.052","article-title":"Intravascular Ultrasound Guided Recanalization of Stumpless Chronic Total Occlusion","volume":"148","author":"Park Y.","year":"2011","journal-title":"International Journal of Cardiology"},{"issue":"7","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1016\/S0735-1097(02)01733-3","article-title":"A Contemporary Overview of Percutaneous Coronary Interventions","volume":"39","author":"Anderson H. V.","year":"2002","journal-title":"Journal of the American College of Cardiology"},{"issue":"5","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1111\/joic.12518","article-title":"Intravascular Ultrasound Guided Wiring Re\u2010Entry Technique for Complex Chronic Total Occlusions","volume":"31","author":"Huang W. C.","year":"2018","journal-title":"Journal of Interventional Cardiology"},{"issue":"15","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1016\/j.jacc.2006.12.040","article-title":"Trends in Outcomes After Percutaneous Coronary Intervention for Chronic Total Occlusions","volume":"49","author":"Prasad A.","year":"2007","journal-title":"Journal of the American College of Cardiology"},{"issue":"2","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.jccase.2017.04.007","article-title":"Slipstream Technique\u201d\u2014New Concept of Intravascular Ultrasound Guided Wiring Technique with Double Lumen Catheter in the Treatment of Coronary Total Occlusions","volume":"16","author":"Kinoshita Y.","year":"2017","journal-title":"Journal of Cardiology Cases"},{"issue":"2","key":"e_1_2_10_7_1","first-page":"155","article-title":"A Novel Modification of the Retrograde Approach for the Recanalization of Chronic Total Occlusion of the Coronary Arteries","volume":"3","author":"Rathore S.","year":"2010","journal-title":"JACC: Cardiovascular Interventions"},{"issue":"15","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"4947","DOI":"10.3390\/jcm12154947","article-title":"Clinical and Procedural Outcomes of IVUS\u2010Guided Vs. Angiography\u2010Guided CTO\u2010PCI: A Systematic Review and Meta\u2010Analysis","volume":"12","author":"Panuccio G.","year":"2023","journal-title":"Journal of Clinical Medicine"},{"issue":"4","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"323","DOI":"10.2174\/1573403X11666150909105827","article-title":"Intravascular Ultrasound Guided Percutaneous Coronary Intervention for Chronic Total Occlusion","volume":"11","author":"Dash D.","year":"2015","journal-title":"Current Cardiology Reviews"},{"issue":"21","key":"e_1_2_10_10_1","first-page":"2135","article-title":"A New Algorithm for Crossing Chronic Total Occlusions From the Asia Pacific Chronic Total Occlusion Club","volume":"10","author":"Harding S. A.","year":"2017","journal-title":"JACC: Cardiovascular Interventions"},{"issue":"1","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1002\/ccd.30904","article-title":"Successful Treatment by Recross IVUS\u2010Guided Reentry in Coronary Total Occlusion: STRIVE\u2010CTO","volume":"103","author":"Ungureanu C.","year":"2023","journal-title":"Catheterization and Cardiovascular Interventions"},{"issue":"4","key":"e_1_2_10_12_1","first-page":"393","article-title":"Use of a Novel Crossing and Re\u2010Entry System in Coronary Chronic Total Occlusions That Have Failed Standard Crossing Techniques","volume":"5","author":"Whitlow P. L.","year":"2012","journal-title":"JACC: Cardiovascular Interventions"},{"issue":"5","key":"e_1_2_10_13_1","first-page":"359","article-title":"Tip Detection\u2013Antegrade Dissection and Re\u2010Entry with New Puncture Wire in CTO Intervention","volume":"4","author":"Tanaka K.","year":"2024","journal-title":"JACC: Asia"},{"issue":"37","key":"e_1_2_10_14_1","article-title":"Successful Combination of the Slipstream and the Tip Detection\u2013Antegrade Dissection and Re\u2010Entry Techniques for Chronic Total Occlusion","volume":"30","author":"Yoshinaga M.","year":"2025","journal-title":"JACC: Case Reports"},{"issue":"5","key":"e_1_2_10_15_1","article-title":"HD\u2010IVUS\u2010Guided Tip Detection\u2013Antegrade Dissection and Re\u2010Entry (TD\u2010ADR)","volume":"30","author":"Li B. H.","year":"2025","journal-title":"JACC: Case Reports"},{"issue":"5","key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1161\/CIRCULATIONAHA.120.046754","article-title":"Definitions and Clinical Trial Design Principles for Coronary Artery Chronic Total Occlusion Therapies: CTO\u2010ARC Consensus Recommendations","volume":"143","author":"Ybarra L. F.","year":"2021","journal-title":"Circulation"},{"issue":"1","key":"e_1_2_10_17_1","first-page":"1","article-title":"Contemporary Issues in Chronic Total Occlusion Percutaneous Coronary Intervention","volume":"15","author":"Azzalini L.","year":"2022","journal-title":"JACC: Cardiovascular Interventions"},{"issue":"10150","key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/S0140-6736(18)31719-7","article-title":"Drug\u2010Coated Balloons for Small Coronary Artery Disease (BASKET\u2010SMALL 2): An Open\u2010Label Randomised Non\u2010Inferiority Trial","volume":"392","author":"Jeger R. V.","year":"2018","journal-title":"Lancet (London, England)"},{"issue":"2","key":"e_1_2_10_19_1","first-page":"213","article-title":"Predicting Successful Guidewire Crossing Through Chronic Total Occlusion of Native Coronary Lesions Within 30 Minutes","volume":"4","author":"Morino Y.","year":"2011","journal-title":"JACC: Cardiovascular Interventions"},{"issue":"23","key":"e_1_2_10_20_1","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1016\/j.scib.2018.09.015","article-title":"Active Greeting Technique: A Mother\u2010And\u2010Child Catheter Based Technique to Facilitate Retrograde Wire Externalization in Recanalization of Coronary Chronic Total Occlusion","volume":"63","author":"Ge J.","year":"2018","journal-title":"Science Bulletin"},{"issue":"6","key":"e_1_2_10_21_1","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1002\/ccd.21219","article-title":"Intravascular Ultrasound\u2010Guided Wiring for Chronic Total Occlusion","volume":"70","author":"Furuichi S.","year":"2007","journal-title":"Catheterization and Cardiovascular Interventions"},{"issue":"2","key":"e_1_2_10_22_1","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.amjcard.2004.09.009","article-title":"Value of Preprocedure Multislice Computed Tomographic Coronary Angiography to Predict the Outcome of Percutaneous Recanalization of Chronic Total Occlusions","volume":"95","author":"Mollet N. R.","year":"2005","journal-title":"The American Journal of Cardiology"},{"issue":"4","key":"e_1_2_10_23_1","first-page":"742","article-title":"Move the Cap\u201d Technique for Ambiguous or Impenetrable Proximal Cap of Coronary Total Occlusion","volume":"87","author":"Vo M. N.","year":"2015","journal-title":"Catheterization and Cardiovascular Interventions"},{"issue":"1","key":"e_1_2_10_24_1","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1002\/ccd.31306","article-title":"Management of Chronic Total Occlusion With Heavily Calcified Distal Cap: Three\u2010Dimensional Vascular Wall Assessment Enables Move\u2010the\u2010Cap Technique via Retrograde Approach","volume":"105","author":"Matsumura H.","year":"2024","journal-title":"Catheterization and Cardiovascular Interventions"},{"issue":"8","key":"e_1_2_10_25_1","doi-asserted-by":"crossref","DOI":"10.1093\/ehjcr\/ytae378","article-title":"Tip Detection\u2010Antegrade Dissection and Re\u2010Entry (TD\u2010ADR) with Integrated Fluoroscopic and Intravascular Ultrasound Images in Chronic Total Occlusion: First Case Report of Integrated TD\u2010ADR Technique","volume":"8","author":"Tadano Y.","year":"2024","journal-title":"European Heart Journal \u2010 Case Reports"},{"issue":"2","key":"e_1_2_10_26_1","first-page":"219","article-title":"New Frontiers in Antegrade Wiring from the Asia Pacific Chronic Total Occlusion Club","volume":"5","author":"Wu E. B.","year":"2025","journal-title":"JACC: Asia"},{"issue":"1","key":"e_1_2_10_27_1","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1002\/ccd.30920","article-title":"Intravascular Ultrasound\u2010Guided STAR 2.0: A New Technique for Chronic Total Occlusion Recanalization","volume":"103","author":"Garbo R.","year":"2023","journal-title":"Catheterization and Cardiovascular Interventions"},{"issue":"6","key":"e_1_2_10_28_1","first-page":"961","article-title":"New CTO\u2010Specific IVUS","volume":"2","author":"Suzuki S.","year":"2020","journal-title":"JACC: Case Reports"},{"issue":"6","key":"e_1_2_10_29_1","doi-asserted-by":"crossref","DOI":"10.1093\/ehjcr\/ytac233","article-title":"Tip Detection\u2010Antegrade Dissection and Reentry Using Intravascular Ultrasound in Chronic Total Occlusion Intervention: First Human Case Report","volume":"6","author":"Suzuki S.","year":"2022","journal-title":"European Heart Journal\u2014Case Reports"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70744","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.70744","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70744","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:16:50Z","timestamp":1785849410000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.70744"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,4]]},"references-count":28,"alternative-id":["10.1002\/ccd.70744"],"URL":"https:\/\/doi.org\/10.1002\/ccd.70744","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,4]]},"assertion":[{"value":"2026-01-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ccd.70744"}}