TD-ADR
Tip Detection assisted Antegrade Dissection and Re-entry
Tip Detection enables precise control of the wire tip in the subintimal space during re-entry maneuvers, improving accuracy in identifying the true lumen and reducing unnecessary vessel trauma.
TD-HDR
By using real-time guidance, operators can precisely orient the wire to re-enter into the CTO body from the subintimal space thus enabling hydrodynamic contrast recanalization.
TD-parallel wiring
Once the first guidewire has entered the subintimal space, tip detection provides precise control of the wire tip within the CTO segment, enabling more faithful tracking of the coronary anatomy and reducing avoidable vessel trauma.
Bifurcation Stenting
With tip detection, operators can visually and mechanically guide the wire through specific distal stent struts, optimizing access and stent apposition in bifurcation lesions.
TD Side Branch Wiring
Tip detection helps target and enter small or challenging side branches with enhanced precision, ensuring safe navigation and minimizing the risk of wire-induced damage.
IVUS-guided TD Proximal Cap Puncture
Tip detection allows for a meticulously planned proximal cap puncture, particularly in ambiguous or calcified proximal segments.
TD-assisted "move the cap"
When the cap cannot be identifed and punctured, Tip detection can assist in maintaining directional accuracy during the clarification of the cap process, facilitating for example a controlled and efficient “scratch and go” strategy.
IVUS-guided TD reverse-CART
This application uses antegrade IVUS visualization to actively align the retrograde wire for a precise connection, minimizing subintimal space creation and resolving complex reverse-CART scenarios.
Applications of Tip Detection
in Complex PCI
In the evolving landscape of complex PCI, tip detection (TD) is the cornerstone of the TD-PCI methodology — a philosophy that transforms wire control from an empirical art into a reproducible and fully controlled IVUS-guided science. Mastering TD unlocks a new level of precision, confidence, and efficiency in tackling the most demanding coronary anatomies.
Below are some of the possible key applications of TD within this framework, each representing a step forward in understanding and controlling the dynamics of wire behavior. These contrast-free techniques not only expand procedural options but also redefine how operators visualize and execute advanced PCI strategies.