Journal of Invasive Cardiology

Venture wire control catheter is a deflectable-tip catheter that is traditionally used to facilitate wire crossing of tortuous coronary vessels, coronary bifurcations, navigate acute bends and side branches jailed by stents. The directional control of the guidewire achieved through this device may also be very useful during engagement of coronary CTO. In this series of upcoming blogs I will be discussing use of specific devices for percutaneous treatment of coronary CTO.

In a report recently published from our group by Iturbe et al the use of Venture catheter has been described along with tip and tricks.

The potential applications of Venture for PCI of coronary CTO include:

(A) Directing the guide wire precisely into and across a blunt vessel occlusion with a large side branch.

(B) Angulation of the guide wire away from side branches during passage through the body of the CTO.

(C) Extra support during crossing of CTO at acute angulations by preventing guide wire prolapse.

(D) Wire exchange as well as drug delivery though an over-the-wire Venture catheter.

(E) Sub-intimal space to true lumen re-entry.

The Venture catheter is 6F compatible and with 0.014 inch guide wires. Both a rapid exchange and an over-the-wire catheter are available. The tip rotating diameter is approximately 2.5 mm, hence a vessel diameter > 2.5 mm makes the manipulations effortless and safe, especially around steep angulations. The risk in this situation is of vessel dissection. Another word of caution is regarding the risk of coronary perforation when the Venture catheter is combined with super-stiff CTO specific guide wires. During true-lumen re-entry form the sub-intimal space the passage of the Venture catheter through the sub-intimal space can inadvertently enrage the sub-intimal space and increase the distance for the space to the distal vessel true lumen, further complicating the re-entry procedure.

Sub-intimal space to true-lumen entry technique using a Venture catheter will soon be reported in the one of the upcoming issues of this journal by our group.

I believe that the venture catheter, in the hands of operator with CTO specific expertise can truly facilitate the procedure and make CTO treatment more reliable, efficient and safe.

Dr Subhash Banerjee is a board certified Interventional Cardiologist and Endovascular specialist. He is the Chief of cardiology at VA North Texas Health Care System and an Assistant Professor of medicine UT Southwestern Medical Center in Dallas, TX. Dr Banerjee serves as a national proctor, teaching physicians the techniques of endovascular therapy for coronary and peripheral interventions. Dr Banerjee leads an active clinical research program focused on anti-platelet therapy, DES, and peripheral interventions. He is widely published and is funded by national peer-reviewed grants.