{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:28:55Z","timestamp":1787117335844,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"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>CTO PCI success depends on consistent equipment performance. Equipment friction (Stingray guidewire lumen fatigue, microcatheter internal lumen friction, and retrograde externalization friction) causes procedural delay and failure. The standard solution is device exchange, which is time\u2010consuming and adds cost. To our knowledge, no published technique addresses CTO\u2010specific equipment friction with an alternative to Rotaglide, which is unavailable in most countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This report aims to describe and illustrate the Propoglide technique, the use of propofol 1% lipid emulsion as an off\u2010label lubricant to overcome equipment friction in CTO PCI across three clinically distinct scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We describe the Propoglide technique: propofol 1% lipid emulsion (soybean oil carrier) applied as an off\u2010label lubricant across three CTO PCI scenarios: (A) Stingray balloon guidewire lumen, (B) microcatheter inner lumen, and (C) retrograde externalization. Device\u2010specific dead space estimates for common coronary microcatheters guide propofol volume selection. Three illustrative cases demonstrate clinical application.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Propofol lubrication resolved friction\u2010related failure in all illustrated cases, restoring device function within a single application without device exchange. Propofol volumes ranged from 0.3 to 0.8\u2009mL (3\u20138\u2009mg), pharmacologically negligible relative to sedation doses. No adverse events were observed in the illustrative cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Propofol 1% emulsion provides practical, safe lubrication for CTO PCI equipment across three clinically distinct friction scenarios, with particular relevance in settings where dedicated lubricants and externalization wires are unavailable. Prospective validation is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70831","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:18:56Z","timestamp":1787116736000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Propofol\u2010Based Lubrication to Overcome Equipment Friction in Chronic Total Occlusion PCI: The Propoglide Technique"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9926-5081","authenticated-orcid":false,"given":"Evandro","family":"Martins Filho","sequence":"first","affiliation":[{"name":"Harrington Heart &amp; Vascular Institute University Hospitals Cleveland Medical Center Cleveland Ohio USA"},{"name":"Case Western Reserve University School of Medicine Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marielle Rodrigues","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hospital Regional de Mato Grosso do Sul Campo Grande Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6252-6708","authenticated-orcid":false,"given":"Ricardo F. O.","family":"Suruagy Motta","sequence":"additional","affiliation":[{"name":"University Center CESMAC Macei\u00f3 Alagoas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1989-1670","authenticated-orcid":false,"given":"Gustavo N.","family":"Araujo","sequence":"additional","affiliation":[{"name":"Hospital da Unimed Grande Florian\u00f3polis S\u00e3o Jos\u00e9 Brazil"},{"name":"Instituto de Cardiologia de Santa Catarina S\u00e3o Jos\u00e9 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7837-2153","authenticated-orcid":false,"given":"Ant\u00f4nio Carlos","family":"Botelho","sequence":"additional","affiliation":[{"name":"Hospital S\u00e3o Jos\u00e9 do Ava\u00ed Itaperuna Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"issue":"5","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1161\/CIRCULATIONAHA.119.039797","article-title":"Guiding Principles for Chronic Total Occlusion Percutaneous Coronary Intervention","volume":"140","author":"Brilakis E. 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S.","year":"2012","journal-title":"JACC: Cardiovascular Interventions"},{"issue":"11","key":"e_1_2_12_5_1","first-page":"579","article-title":"Long\u2010Term Outcomes With Use of the Crossboss and Stingray Coronary CTO Crossing and Re\u2010Entry Devices","volume":"25","author":"Mogabgab O.","year":"2013","journal-title":"Journal of Invasive Cardiology"},{"issue":"7","key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1002\/ccd.28607","article-title":"Advances in CrossBoss\/Stingray Use in Antegrade Dissection Reentry From the Asia Pacific Chronic Total Occlusion Club","volume":"96","author":"Wu E. B.","year":"2020","journal-title":"Catheterization and Cardiovascular Interventions"},{"key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"104","DOI":"10.12659\/AJCR.902178","article-title":"Initial Experience and Feasibility of the New Low\u2010Profile Stingray Catheter as Part of the Antegrade Dissection and Re\u2010Entry Revascularization Strategy for Coronary Chronic Total Occlusions","volume":"18","author":"Maeremans J.","year":"2017","journal-title":"American Journal of Case Reports"},{"key":"e_1_2_12_8_1","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2022.724608","article-title":"Guiding Principles for the Clinical Use and Selection of Microcatheters in Complex Coronary Interventions","volume":"9","author":"Goel P. K.","year":"2022","journal-title":"Frontiers in Cardiovascular Medicine"},{"issue":"4","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1080\/17434440.2019.1602039","article-title":"Recent Advances in Microcatheter Technology for the Treatment of Chronic Total Occlusions","volume":"16","author":"Vemmou E.","year":"2019","journal-title":"Expert Review of Medical Devices"},{"issue":"4","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"E90","DOI":"10.1002\/ccd.26568","article-title":"Guidewire and Microcatheter Utilization Patterns During Antegrade Wire Escalation in Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry","volume":"89","author":"Karatasakis A.","year":"2017","journal-title":"Catheterization and Cardiovascular Interventions"},{"issue":"3","key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1002\/ccd.25611","article-title":"Chronic Total Occlusion Percutaneous Coronary Intervention Case Selection and Techniques for the Antegrade\u2010Only Operator","volume":"85","author":"Rinfret S.","year":"2015","journal-title":"Catheterization and Cardiovascular Interventions"},{"issue":"5","key":"e_1_2_12_12_1","article-title":"North American Expert Review of Rotational Atherectomy","volume":"12","author":"Sharma S. K.","year":"2019","journal-title":"Circulation: Cardiovascular Interventions"},{"issue":"5","key":"e_1_2_12_13_1","first-page":"146","article-title":"Injecting Lubricant into the Guiding Catheter Enables Stent Deployment","volume":"18","author":"Dobies D. R.","year":"2006","journal-title":"Journal of Invasive Cardiology"},{"key":"e_1_2_12_14_1","volume-title":"Manual of Chronic Total Occlusion Percutaneous Coronary Interventions: A Step\u2010by\u2010Step Approach","author":"Brilakis E. S.","year":"2023"},{"key":"e_1_2_12_15_1","volume-title":"Diprivan (Propofol) Injectable Emulsion, USP [Package Insert], NDA 019627","author":"Fresenius Kabi USA, LLC","year":"2020"},{"key":"e_1_2_12_16_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijpharm.2019.118998","article-title":"Coexistence of Oil Droplets and Lipid Vesicles in Propofol Drug Products","volume":"577","author":"Wu Y.","year":"2020","journal-title":"International Journal of Pharmaceutics"},{"issue":"2","key":"e_1_2_12_17_1","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1002\/ccd.20943","article-title":"Facilitated Stent Delivery Using Applied Topical Lubrication","volume":"69","author":"Singh A.","year":"2007","journal-title":"Catheterization and Cardiovascular Interventions"},{"issue":"6","key":"e_1_2_12_18_1","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/j.hrcr.2020.02.014","article-title":"The Use of Lubricating Solution as a Novel Method in Facilitating Left Ventricular Lead Placement: A Case Series","volume":"6","author":"Kazemian P.","year":"2020","journal-title":"HeartRhythm Case Reports"},{"issue":"1","key":"e_1_2_12_19_1","first-page":"25","article-title":"Alternative Rota\u2010Flush Solution for Patients With Severe Coronary Artery Calcification Who Undergo Rotational Atherectomy","volume":"29","author":"Lee M. S.","year":"2017","journal-title":"Journal of Invasive Cardiology"},{"issue":"8","key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/j.bjoms.2010.12.003","article-title":"Use of Propofol Emulsion for Intra\u2010Operative Lubrication of Oral and Maxillofacial Surgical Instruments","volume":"49","author":"Herd M. K.","year":"2011","journal-title":"British Journal of Oral and Maxillofacial Surgery"},{"issue":"11","key":"e_1_2_12_21_1","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1080\/17434440.2017.1384695","article-title":"Orbital Atherectomy for the Treatment of Severely Calcified Coronary Lesions: Evidence, Technique, and Best Practices","volume":"14","author":"Shlofmitz E.","year":"2017","journal-title":"Expert Review of Medical Devices"},{"issue":"6","key":"e_1_2_12_22_1","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCINTERVENTIONS.115.003434","article-title":"Outcomes With Use of the Retrograde Approach for Coronary Chronic Total Occlusion Interventions in a Contemporary Multicenter US Registry","volume":"9","author":"Karmpaliotis D.","year":"2016","journal-title":"Circ Cardiovasc Interv"},{"issue":"8","key":"e_1_2_12_23_1","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1097\/MCA.0000000000000668","article-title":"Safety and Efficacy of Dedicated Guidewire and Microcatheter Technology for Chronic Total Coronary Occlusion Revascularization: Principal Results of the Asahi Intecc Chronic Total Occlusion Study","volume":"29","author":"Kandzari D. 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