The Microchannel Technique

The microchannel technique is an antegrade method of chronic total occlusion (CTO) recanalization that utilizes the microvessels present within the occluded coronary artery segment. This chapter presents the principles of the microchannel technique. Initially, it is important to assess each CTO lesion and determine whether the characteristics are favorable for recanalization using this technique. The concept of intra-plaque therapy was developed for the successful treatment of the CTO. The methods of intra-plaque therapy present the disadvantage of a first step procedure to allow plaque modification performed at a different time. The microchannel technique should instead be carried out at the same time as the diagnostic procedure. The specifics of the microinjection are completely different between the STAR technique and the microchannel technique, however both methods utilize so-called "hydrody-namic recanalization" of the CTO.