The confluent balloon technique--two cases illustrating a novel method to achieve rapid wire crossing of chronic total occlusion during retrograde approach percutaneous coronary intervention.

We describe two cases of a retrograde approach to treat a chronic total occlusion (CTO) of the right coronary artery in which we were initially unable to achieve wire crossing. A novel technique of pushing both antegrade and retrograde balloons into the CTO lesion so that the balloons overlapped each other during inflation created a new confluent subintimal space allowing easy, reliable and rapid passing of the retrograde wire into the antegrade true lumen. This novel "confluent balloon" method is recommended to other operators who may struggle with wire crossing during a retrograde approach to CTOs.