DLMs can be particularly helpful in challenging side branch wiring due to highly angulated (angles ≥ 150°) side branches, or those with unfavorable take-off angles when conventional wiring techniques have failed. 3 It remains one of the most challenging subsets of lesions, often due to difficulty in wiring of the side branch. Their application is most useful in the setting of PCI for bifurcation lesions, CTOs, and a combination of the two ( Table 1).Ĭoronary bifurcation PCI accounts for approximately 20% of all PCI procedures and is associated with increased procedural cost, higher complication rates, and worse outcomes. The role for DLMs is expanding and will likely continue to grow with the increase in complexity of PCI. Martins Filho from this issue for additional reading. 2 This article focuses on the currently available DLMs and their applications. However, all share the common feature of two distinct lumens to facilitate the precise handling of two separate guidewires. Each device has unique design characteristics. Several DLMs are currently available and the role for their utilization is expanding. 1 Dual lumen microcatheters (DLMs) have recently been introduced to further facilitate PCI of complex anatomy. The use of novel techniques and devices, such as microcatheters, has become essential in increasing the success rate of these more complex interventions. Additionally, there has been an uptake in the treatment of chronic total occlusions (CTOs), which pose a particular challenge for percutaneous revascularization as opposed to bypass.

Patients undergoing PCI are older, have more comorbidities, prior coronary bypass grafts, and more heavily calcified and tortuous lesions that often involve coronary bifurcations. The complexity of percutaneous coronary intervention (PCI) in the current era has increased significantly.

Double lumen foley catheter