Ping-Pong Guide Catheters to Facilitate Real-Time Intravascular Ultrasound-Guided Recanalization of Stumpless Chronic Total Occlusion

Abstract Stumpless chronic total occlusion is associated with a higher failure rate of recanalization. Intravascular ultrasound (IVUS) is useful for identifying the entry point; however, 8-F guide catheters are necessary for real-time IVUS-guided wiring. This case reports the novel use of the “ping-pong” guide catheter technique to facilitate real-time IVUS-guided wiring for a stumpless chronic total occlusion. (Level of Difficulty: Advanced.)