🌍 Global Debut! Fuwai Hospital’s Innovative RWT Technique Published in Top International Journal: Redefining Standards for "Extreme-Angled" Coronary Interventions

🩺 [Clinical Profile]: Coronary bifurcation lesions account for $15\% \sim 20\%$ of PCI procedures. When the bifurcation angle $\alpha$ presents extreme or unfavorable angulation, standard guidewire passage becomes nearly impossible. While Dual-Lumen Microcatheters (DLC) are traditional aids, they often lack maneuverability in short main vessel segments or confined spaces due to their bulky profile, leading to procedural failure or guidewire dislodgement.

⚖️ [Decision Logic]: The expert team at Fuwai Hospital addressed this bottleneck by innovating the Reversed Wire Technique (RWT) utilizing a conventional Single-Lumen Microcatheter (SLMC). The rationale is to leverage the SLMC's superior trackability and minimal crossing profile to facilitate precise re-entry and branch engagement in restricted anatomical spaces.

🛠️ [Technical Granularity]: The team articulated the procedure into four critical phases:

📐 Shaping: A high-lubricity Fielder XT-R guidewire is shaped to an angle complementary to the lesion's $\alpha$, with a reverse fold created $2 \sim 3\text{cm}$ from the tip.

🔩 Loading: Utilizing the Retrograde Loading method, the wire tail is inserted through the SLMC tip to constrain the pre-set "hairpin" geometry.

🧬 Engagement: The assembly is advanced to the lesion; the SLMC is retracted to deploy the fold, allowing the wire to "hook" into the extreme branch via elastic recoil.

✅ Exchange: Unlike DLCs, the SLMC can be rapidly advanced to support wire exchange, eliminating the risk of wire dislodgement associated with catheter withdrawal.

✨ [Third-Party Perspective]: By achieving a near $100\%$ success rate across 22 complex cases, the Fuwai Hospital team has demonstrated that procedural ingenuity can outweigh hardware cost. This technique, now peer-reviewed in CVIT, establishes a new global benchmark for cost-effective, high-precision interventional cardiology.