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https://www.readbyqxmd.com/read/28434645/comparison-of-outcomes-in-men-versus-women-after-percutaneous-coronary-intervention-for-chronic-total-occlusion
#1
Barbara Elisabeth Stähli, Cathérine Gebhard, Michael Gick, Miroslaw Ferenc, Kambis Mashayekhi, Heinz Joachim Buettner, Franz-Josef Neumann, Aurel Toma
Conflicting evidence exists on gender differences in outcomes after coronary stenting, and gender-based data in patients with chronic total occlusions (CTO) who underwent percutaneous coronary intervention (PCI) are scarce. Consecutive patients who underwent CTO PCI from January 2005 to December 2013 were included in the analysis and stratified according to gender. The primary outcome measure was all-cause mortality. Median follow-up was 2.6 years (interquartile range 1.1 to 3.1). Of 2002 patients, 332 (17%) were women...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28432004/impact-of-right-ventricular-side-branch-occlusion-during-percutaneous-coronary-intervention-of-chronic-total-occlusions-on-right-ventricular-function
#2
Pepijn A van Diemen, Wynand J Stuijfzand, Stefan P Biesbroek, Pieter G Raijmakers, Roel S Driessen, Stefan P Schumacher, Alexander Nap, Albert C van Rossum, Niels van Royen, Robin Nijveldt, Paul Knaapen
OBJECTIVE: To determine the impact of right ventricular side branch (RVB) occlusion, during percutaneous coronary interventions (PCIs) of chronic total occlusions (CTOs) of the right coronary artery (RCA), on right ventricular (RV) function. BACKGROUND: Developments in PCI techniques have expanded PCI CTO feasibility. However, the utilization of dissection and reentry techniques and extensive stent implantation increases the risk of coronary side branch occlusion...
April 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28425767/chronic-total-coronary-occlusion-treatment-results
#3
Martin Kirk Christensen, Phillip Fischer Freeman, Jeppe Groendal Rasmussen, Anton Boel Villadsen, Bent Raungaard, Svend Eggert Jensen, Leif Thuesen
OBJECTIVES: To describe the clinical and procedural coronary chronic total occlusion (CTO) treatment results in a Nordic PCI centre during the implementation of a CTO treatment program. DESIGN: In a retrospective registry study, we assessed; (1) indication for the procedure, (2) Canadian Cardiovascular Society angina pectoris score (CCS)/New York Heart Association (NYHA) heart failure score, (3) lesion complexity and (4) adverse events during hospital stay and three months following the index procedure...
April 20, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28419791/the-role-of-rotational-atherectomy-in-contemporary-chronic-total-occlusion-percutaneous-coronary-intervention
#4
EDITORIAL
Yader Sandoval, Emmanouil S Brilakis
Rotational atherectomy is performed infrequently (∼3.5%) during chronic total occlusion (CTO) percutaneous coronary intervention (PCI) for two indications: treatment of balloon uncrossable and balloon undilatable lesions. Use of rotational atherectomy in CTO PCI was associated with high success and acceptable complication rates. Rotational atherectomy remains a "must have" device for interventional cardiologists performing complex PCI.
April 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28412256/procedural-and-long-term-outcomes-of%C3%A2-percutaneous-coronary-intervention-for%C3%A2-in-stent-chronic-total-occlusion
#5
Lorenzo Azzalini, Rustem Dautov, Soledad Ojeda, Susanna Benincasa, Barbara Bellini, Francesco Giannini, Jorge Chavarría, Manuel Pan, Mauro Carlino, Antonio Colombo, Stéphane Rinfret
OBJECTIVES: The study sought to investigate the long-term outcomes and predictors of adverse events of percutaneous coronary intervention (PCI) for in-stent chronic total occlusion (IS-CTO). BACKGROUND: IS-CTO PCI has traditionally been associated with suboptimal success rates. METHODS: We performed a multicenter registry of consecutive patients undergoing CTO PCI at 3 specialized centers. Patients were divided in IS-CTO and de novo CTO. The primary endpoint (major adverse cardiac events [MACE]) was a composite of cardiac death, target-vessel myocardial infarction, and ischemia-driven target-vessel revascularization (TVR) on follow-up...
April 12, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28385401/vascular-access-site-and-outcomes-among-26-807-chronic-total-coronary-occlusion-angioplasty-cases-from-the-british-cardiovascular-interventions-society-national-database
#6
Tim Kinnaird, Richard Anderson, Nick Ossei-Gerning, Sean Gallagher, Adrian Large, Julian Strange, Peter Ludman, Mark de Belder, James Nolan, David Hildick-Smith, Mamas Mamas
OBJECTIVES: The aim of this study was to assess, using a national percutaneous coronary intervention (PCI) database, access-site choice and outcomes after chronic total occlusion (CTO) PCI. BACKGROUND: Given the influence of access site on outcomes, the use of radial access in CTO PCI warrants further investigation. METHODS: Data were analyzed from the British Cardiovascular Intervention Society dataset of 26,807 elective CTO PCI procedures performed in England and Wales between 2006 and 2013...
April 10, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28373785/chronic-total-coronary-occlusion-recanalization-current-techniques-and-new-devices
#7
REVIEW
Jan-Erik Gülker, Lars Bansemir, Heinrich G Klues, Alexander Bufe
Percutaneous coronary intervention (PCI) of total chronic coronary occlusion (CTO) still remains a major challenge. The prevalence of a CTO has been reported to be up to 30% among patients with a clinical indication for coronary angiography. Progress has been made with further advanced interventional techniques and continuously sophisticated interventional tools. Nevertheless the number of interventions carried out to recanalize a CTO is less than 10% of all procedures. Benefits of a successful CTO recanalization include relief of angina pectoris and ischemia-related dyspnea, substantial improvement in left ventricular function and, avoidance of surgery treatment...
April 2017: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/28366607/influence-about-the-flow-of-distal-branch-after-intervention-of-the-right-coronary-artery-chronic-total-occlusion
#8
Hsiu-Yu Fang, Chiung-Jen Wu, Chih-Yuan Fang, Wei-Chieh Lee
OBJECTIVE: Limited data are available for the clinical outcomes after the recanalization of right coronary artery (RCA) chronic total occlusion (CTO). The study aims to assess the clinical outcomes in the antegrade flow of the distal branch after successful RCA CTO percutaneous coronary intervention (PCI). METHODS: Between January 2002 and December 2012, 538 patients who underwent RCA CTO PCI were enrolled. The clinical outcomes as myocardial infarction (MI), target vessel revascularization, cardiac death, major adverse cardiac events, and all-cause mortality, were compared to the antegrade flow of distal branch after successful RCA CTO PCI...
March 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28341287/outcomes-of-the-retrograde-approach-through-epicardial-versus-non-epicardial-collaterals-in-chronic-total-occlusion-percutaneous-coronary-intervention
#9
Susanna Benincasa, Lorenzo Azzalini, Mauro Carlino, Barbara Bellini, Francesco Giannini, Xiaohui Zhao, Antonio Colombo
BACKGROUND: The retrograde approach through epicardial collaterals (EC) for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is a challenging procedure. Our study aim was to evaluate the outcomes of patients undergoing CTO PCI using a retrograde approach through epicardial versus non-epicardial collaterals (NEC). METHODS: We collected data from our single-center registry of consecutive patients undergoing retrograde CTO PCI, performed by an experienced operator through EC and NEC (septals and bypass grafts)...
March 14, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28335895/coronary-collaterals-function-and-clinical-outcome-between-patients-with-acute-and-chronic-total-occlusion
#10
Jang Hoon Lee, Chang-Yeon Kim, Namkyun Kim, Se Yong Jang, Myung Hwan Bae, Dong Heon Yang, Yongkeun Cho, Shung Chull Chae, Hun Sik Park
OBJECTIVES: This study sought to demonstrate how changes in the collateral function and its clinical significance before and after percutaneous coronary interventions (PCIs) are compared between patients with acute coronary syndrome and total or nearly total occlusions (ATOs) and chronic total occlusions (CTOs). BACKGROUND: The functional relevance of the collateral circulation in patients with ATOs and CTOs has not been fully investigated. METHODS: The pressure-derived collateral pressure index (CPI), myocardial fractional flow reserve (FFRmyo), and coronary fractional flow reserve (FFRcor) at maximum hyperemia induced by intravenous adenosine were evaluated in occluded vessels at baseline, after the PCI, and at 1 year in 23 ATO and 74 CTO patients...
March 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28325520/percutaneous-revascularization-of-coronary-chronic-total-occlusion-toward-a-reappraisal-of-the-available-evidence
#11
REVIEW
Pasi P Karjalainen, Wail Nammas
Chronic total occlusion (CTO) is a challenging subset of coronary artery disease that is commonly encountered in real-world practice; it is associated with worse long-term prognosis. Observational studies suggest that percutaneous coronary intervention (PCI) for CTO is associated with reduction in myocardial ischemia and improvement in quality of life and left ventricular function. Some observational studies suggested that CTO-PCI is associated with improvement of the 'hard' clinical endpoints; others did not...
March 18, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28318134/long-term-clinical-outcomes-of-successful-revascularization-with-drug-eluting-stents-for-chronic-total-occlusions-a-systematic-review-and-meta-analysis
#12
REVIEW
Lei Gao, Yabin Wang, Yuqi Liu, Feng Cao, Yundai Chen
OBJECTIVES: To determine whether successful percutaneous coronary intervention (PCI) using drug-eluting stents (DESs) have beneficial effects on long-term outcomes in patients with chronic total occlusions (CTOs) compared with failed PCIs for CTOs. BACKGROUND: Several observational studies have evaluated the long-term clinical outcomes of successful PCIs using DESs for CTOs. However, the results of these studies were inconsistent and inconclusive. METHODS: We searched five online electronic databases to identify all the publications assessing the long-term outcomes of successful and failed PCIs using DESs for CTOs...
March 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28315181/update-on-the-management-of-chronic-total-occlusions-in-coronary-artery-disease
#13
REVIEW
Kathleen Kearney, Ravi S Hira, Robert F Riley, Arun Kalyanasundaram, William L Lombardi
PURPOSE OF THE REVIEW: Chronic total occlusions (CTOs) are found in about a third of patients with coronary artery disease (CAD) and can pose a significant challenge during percutaneous revascularization. However, advances in CTO percutaneous coronary intervention (PCI) strategies, devices, and algorithms have led to significant improvements in successful treatment of CTOs. This review summarizes current management of CTOs in the context of modern PCI techniques and current evidence. RECENT FINDINGS: The hybrid algorithm now provides a standardized, teachable approach to CTO PCI, and success rates are approximately 90% in experienced hands...
April 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28314674/further-validation-of-the-hybrid-algorithm-for-cto-pci-difficult-lesions-same-success
#14
Mir B Basir, Aris Karatasakis, Mohammad Alqarqaz, Barbara Danek, Bavana V Rangan, Emmanouil S Brilakis, Henry Kim, William W O'Neill, Khaldoon Alaswad
OBJECTIVES: To evaluate the success rates and outcome of the hybrid algorithm for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) by a single operator in two different clinical settings. METHODS: We compared 279 consecutive CTO PCIs performed by a single, high-volume operator using the hybrid algorithm in two different clinical settings. Data were collected through the PROGRESS CTO Registry. We compared 145 interventions performed in a community program (cohort A) with 134 interventions performed in a referral center (cohort B)...
February 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28303648/subadventitial-techniques-for-chronic-total-occlusion-percutaneous-coronary-intervention-the-concept-of-vessel-architecture
#15
Lorenzo Azzalini, Mauro Carlino, Emmanouil S Brilakis, Minh Vo, Stéphane Rinfret, Barry F Uretsky, Dimitri Karmpaliotis, Antonio Colombo
Despite improvements in guidewire technologies, the traditional antegrade wire escalation approach to chronic total occlusion (CTO) recanalization is successful in only 60-80% of selected cases. In particular, long, calcified, and tortuous occlusions are less successfully approached with a true-to-true lumen approach. Frequently, the guidewire tracks into the subadventitial space, with no guarantee of distal re-entry into the true lumen. The ability to manage the subadventitial space has been a key step in the tremendous improvement in success rates of contemporary CTO percutaneous coronary intervention (PCI), whether operating antegradely or retrogradely...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28296045/one-year-outcomes-after-successful-chronic-total-occlusion-percutaneous-coronary-intervention
#16
W M Wilson, S J Walsh, A Bagnall, A T Yan, C G Hanratty, M Egred, E Smith, K G Oldroyd, M McEntegart, J Irving, H Douglas, J Strange, J C Spratt
We aimed to determine clinical outcomes 1 year after successful chronic total occlusion (CTO) PCI and, in particular, whether use of dissection and re-entry strategies affects clinical outcomes. Hybrid approaches have increased the procedural success of CTO percutaneous coronary intervention (PCI) but longer-term outcomes are unknown, particularly in relation to dissection and re-entry techniques. Data were collected for consecutive CTO PCIs performed by hybrid-trained operators from 7 United Kingdom (UK) centres between 2012 and 2014...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28256296/prediction-of-functional-recovery-after-percutaneous-coronary-revascularization-for-chronic-total-occlusion-using-late-gadolinium-enhanced-magnetic-resonance-imaging
#17
Tatsuya Nakachi, Shingo Kato, Hidekuni Kirigaya, Naoki Iinuma, Kazuki Fukui, Naka Saito, Tae Iwasawa, Masami Kosuge, Kazuo Kimura, Kouichi Tamura
BACKGROUND: Limited data are available regarding the prediction for functional recovery using late gadolinium enhanced magnetic resonance imaging (LGE MRI) after coronary revascularization for chronic total occlusion (CTO PCI). METHODS: We studied 59 patients (mean age, 66±11 years) who underwent successful CTO PCI. Two-dimensional echocardiography and strain measurements were performed before and 8±2 months after CTO PCI. The findings of segmental assessment were compared with the extent of LGE MRI using a 16-segment model...
February 27, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28255103/percutaneous-coronary-intervention-of-coronary-chronic-total-occlusions-improves-peak-oxygen-uptake-during-cardiopulmonary-exercise-testing
#18
Shuaib M Abdullah, Jeffrey L Hastings, Suwetha Amsavelu, Fransisco Garcia-Morales, Fury Hendrix, Aris Karatasakis, Barbara A Danek, Judit Karacsonyi, Bavana V Rangan, Michele Roesle, Houman Khalili, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: Although coronary chronic total occlusions (CTOs) are treated with percutaneous coronary intervention (PCI) to improve symptoms, studies demonstrating symptom improvement have been mostly limited to questionnaire responses. The current study assessed for changes in peak oxygen uptake during cardiopulmonary exercise testing after CTO-PCI. METHODS: Patients with heart failure or angina symptoms referred for CTO-PCI were prospectively enrolled. The primary outcome of the study was improvement in peak oxygen uptake during cardiopulmonary exercise (CPX) testing 5 months after CTO-PCI...
March 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28244014/gender-based-acute-outcome-in-percutaneous-coronary-intervention%C3%A2-of-chronic-total-coronary-occlusion
#19
J E Guelker, L Bansemir, R Ott, K Kuhr, B Koektuerk, R G Turan, H G Klues, A Bufe
BACKGROUND: Percutaneous coronary intervention (PCI) of total chronic coronary occlusion (CTO) still remains a major challenge. Insignificant data are reported in the literature about gender differences in CTO-PCI in the era of new drug-eluting stents. In this study we analysed the impact of gender on procedural characteristics, complications and acute results. METHODS: Between 2010-2015 we included 780 consecutive patients. They underwent PCI for at least one CTO...
February 27, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28242588/effects-of-successful-percutaneous-coronary-intervention-of-chronic-total-occlusions-on-myocardial-perfusion-and-left-ventricular-function
#20
Wijnand J Stuijfzand, P Stefan Biesbroek, Pieter G Raijmakers, Roel S Driessen, Stefan P Schumacher, Pepijn van Diemen, Jeffrey van den Berg, Robin Nijveldt, Adriaan A Lammertsma, Simon J Walsh, Colm G Hanratty, James C Spratt, Albert C van Rossum, Alexander Nap, Niels van Royen, Paul Knaapen
AIMS: The aim of the present study was to investigate the effects of successful PCI CTO on absolute myocardial blood flow (MBF) and functional recovery. METHODS AND RESULTS: Patients with a documented CTO were prospectively examined for ischemia and viability with H215O positron emission tomography (PET) and late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMR). Sixty-nine consecutive patients, in whom PCI was successful, underwent follow-up PET and CMR after approximately 12 weeks to evaluate potential improvement of MBF as well as systolic function...
February 28, 2017: EuroIntervention
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