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CTO PCI

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https://www.readbyqxmd.com/read/28197870/intravascular-ultrasound-guidance-of-percutaneous-coronary-intervention-in-ostial-chronic-total-occlusions-a-description-of-the-technique-and-procedural-results
#1
Nicola Ryan, Nieves Gonzalo, Philip Dingli, Oscar Vedia Cruz, Pilar Jiménez-Quevedo, Luis Nombela-Franco, Ivan Nuñez-Gil, María Del Trigo, Pablo Salinas, Carlos Macaya, Antonio Fernandez-Ortiz, Javier Escaned
Inability to cross the lesion with a guidewire is the most common reason for failure in percutaneous revascularization (PCI) of chronic total occlusions (CTOs). An ostial or stumpless CTO is an acknowledged challenge for CTO recanalization due to difficulty in successful wiring. IVUS imaging provides the opportunity to visualize the occluded vessel and to aid guidewire advancement. We review the value of this technique in a single-centre experience of CTO PCI. This series involves 22 patients who underwent CTO-PCI using IVUS guidance for stumpless CTO wiring at our institution...
February 14, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28185704/everolimus-versus-zotarolimus-eluting-stent-following-percutaneous-coronary-chronic-total-occlusion-intervention
#2
Pil Hyung Lee, Min Soo Cho, Seung-Whan Lee, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
BACKGROUND: Although studies have demonstrated comparable efficacy and safety profiles of everolimus- and zotarolimus-eluting stents (EES and ZES, respectively) for a broad spectrum of coronary artery diseases, there is paucity of data concerning their safety and efficacy for coronary chronic total occlusions (CTOs). This study compared the clinical performance of EES and ZES following successful percutaneous coronary intervention for CTOs. METHODS: The cohort included 539 consecutive CTO patients who underwent successful PCI using EES (n=313) and ZES (n=226) between September 2006 and August 2014...
February 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28185396/primary-percutaneous-coronary-intervention-of-native-chronic-total-occlusions-to-treat-st-elevation-myocardial-infarction-secondary-to-acute-vein-graft-occlusion
#3
Pierre Deharo, Julian W Strange, Abdul Mozid
Primary percutaneous coronary intervention (PCI) is the treatment modality of choice in patients presenting with ST elevation myocardial infarction (STEMI). Clinical outcomes have dramatically improved with the wide adoption of primary PCI in patients with STEMI because of acute thrombotic native coronary artery occlusion. However, patients with prior coronary artery bypass graft (CABG) surgery who present with STEMI because of acute saphenous vein graft (SVG) occlusion continue to have worse outcomes because of poor acute and long-term results of SVG stenting...
February 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28183464/transradial-coronary-interventions-for-complex-chronic-total-occlusions
#4
Yutaka Tanaka, Noriaki Moriyama, Tomoki Ochiai, Takuma Takada, Kazuki Tobita, Koki Shishido, Kazuya Sugitatsu, Futoshi Yamanaka, Shingo Mizuno, Masato Murakami, Junya Matsumi, Saeko Takahashi, Takeshi Akasaka, Shigeru Saito
OBJECTIVES: The aims of this study were to assess whether the transradial approach can be applied to treat complex chronic total occlusion (CTO) and to determine the predictors of transradial percutaneous coronary intervention (PCI) failure. BACKGROUND: Consistent data on the outcomes of transradial PCI for treating CTO are scarce. METHODS: Consecutive patients who were not receiving hemodialysis and had undergone PCI for CTO were enrolled...
February 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28169213/long-term-clinical-outcomes-of-patients-with-coronary-chronic-total-occlusion-treated-with-percutaneous-coronary-intervention-versus-medical-therapy-according-to-presence-of-diabetes-mellitus
#5
Ki Hong Choi, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Hyeon-Cheol Gwon, Sang Hoon Lee, Seung-Hyuk Choi
AIMS: The aim of this study was to compare the long-term clinical outcomes of patients with chronic total occlusion (CTO) treated with percutaneous coronary intervention (PCI) versus medical therapy (MT) according to the presence of diabetes mellitus. METHODS AND RESULTS: A total of 845 patients without diabetes and 702 patients with diabetes were included from the Samsung Medical Center CTO registry. The inverse probability of treatment weighted (IPTW) method was used to adjust for confounding factors...
February 7, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28169091/predictors-of-excess-patient-radiation-exposure-during-chronic-total-occlusion-coronary-intervention-insights-from-a-contemporary-multicentre-registry
#6
Georgios E Christakopoulos, Georgios Christopoulos, Dimitri Karmpaliotis, Khaldoon Alaswad, Robert W Yeh, Farouc A Jaffer, Michael R Wyman, William L Lombardi, Muhammad Nauman J Tarar, J Aaron Grantham, David E Kandzari, Nicholas Lembo, Jeffrey W Moses, Ajay J Kirtane, Manish Parikh, Philip Green, Matthew Finn, Santiago Garcia, Anthony H Doing, Raja Hatem, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: High patient radiation dose during chronic total occlusion (CTO) percutaneous coronary intervention (PCI) might lead to procedural failure and radiation skin injury. METHODS: We examined the association between several clinical and angiographic variables on patient air kerma (AK) radiation dose among 748 consecutive CTO PCIs performed at 9 experienced US centres between May 2012 and May 2015. RESULTS: The mean age was 65 ± 10 years, 87% of patients were men, and 35% had previous coronary artery bypass graft surgery (CABG)...
November 11, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28145879/late-double-barrel-lumen-following-successful-cto-pci-using-the-crossboss-stingray-system
#7
James Roy, David Rees, David Ramsay, James Weaver
There remains limited randomized controlled trials on long-term clinical outcomes after chronic total occlusion percutaneous coronary intervention (CTO-PCI). New techniques involving dissection of the subintimal space and reentry into the true lumen increase success rates in CTO-PCI. However, their longer-term safety and efficacy remain unknown and poorly studied. We present a case of double-lumen formation seen at 1 year post CTO-PCI using subintimal dissection reentry with late restoration of major side branches...
February 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28115803/retrograde-approach-is-as-effective-and-safe-as-antegrade-approach-in-contemporary-percutaneous-coronary-intervention-for-chronic-total-occlusion-a-taiwan-single-center-registry-study
#8
Chih-Kuo Lee, Ying-Hsien Chen, Mao-Shin Lin, Chih-Fan Yeh, Chi-Sheng Hung, Hsien-Li Kao, Ching-Chang Huang
BACKGROUND: In percutaneous coronary intervention (PCI) for chronic total occlusion (CTO), most experts regard the antegrade approach as the default initial strategy, reserving the retrograde approach for reattempts following antegrade failure. In this study, we aimed to compare the efficacy and safety between the antegrade and retrograde approaches in CTO PCI. RESULTS: Between 2012 and 2013, patients that underwent 321 consecutive attempts by high-volume operators (> 75 total CTO PCI cases during the period) in a tertiary university-affiliated hospital were enrolled...
January 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28112448/reduction-of-radiation-exposure-during-complex-interventions-for-chronic-total-coronary-occlusions-implementing-low-dose-radiation-protocols-without-affecting-procedural-success-rates
#9
Gerald S Werner, Peggy Glaser, Anja Coenen, Hiller Moehlis, Karl-Heinz Tischer, Matthias Koch, Reinhold Klingenbeck
BACKGROUND: The increasing complexity of percutaneous coronary intervention (PCI) for chronic total coronary occlusions (CTO) leads to a significant increase of radiation exposure for both patient and operator. OBJECTIVE: To study the potential of modified settings of the X-ray equipment combined with operator protocols to reduce radiation dose despite increasing procedural complexity. PATIENTS AND METHODS: We analyzed a consecutive cohort of 984 PCIs for CTOs in 863 patients between January 2010 and July 2015...
January 23, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28111398/survey-of-exposure-dose-during-percutaneous-coronary-intervention-for-chronic-total-occlusion
#10
Tomokazu Sakano, Tatsushi Iwamoto, Takuya Kuribara, Hajime Sakamoto, Osamu Tajima, Yasuatu Hamano, Masayuki Maruyama, Tatsuya Kikuchi, Atsuko Tsukamoto, Kyouichi Kato
During percutaneous coronary intervention (PCI) for chronic total occlusion (CTO), longer fluoroscopic time as compared with PCI for non-CTO lesions may cause skin injury by increased radiation. We have performed a multi-center observational study comparing the exposed dose during the PCI of CTO (CTO group) and during the PCI of non-CTO lesions (non-CTO group). Exposure doses were assessed in 313 patients with CTO and 3,310 patients with non-CTO lesions. Total fluoroscopy time (59.0 ±35.5 vs 26.8 ±18.8 min, p<0...
2017: Nihon Hoshasen Gijutsu Gakkai Zasshi
https://www.readbyqxmd.com/read/28105600/approach-to-cto-intervention-overview-of-techniques
#11
REVIEW
Aris Karatasakis, Barbara Anna Danek, Dimitri Karmpaliotis, Khaldoon Alaswad, Minh Vo, Mauro Carlino, Mitul P Patel, Stéphane Rinfret, Emmanouil S Brilakis
Successful percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) has been associated with significant clinical benefits, but remains technically demanding. Failure to cross the CTO with a guidewire is the most common cause of CTO PCI failure. CTO crossing can be achieved in the antegrade or retrograde direction and can be accomplished by maintaining true lumen position throughout or via subintimal dissection/reentry techniques. A procedural plan should be created prior to the procedure through careful angiographic review of four key parameters: (a) morphology of the proximal occlusion cap; (b) length of the occlusion; (c) quality of the distal vessel and presence of bifurcation at the distal cap; and (d) suitability of collateral circulation for retrograde crossing...
January 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28100874/efficacy-of-multidetector-computed-tomography-to-predict-periprocedural-myocardial-injury-after-percutaneous-coronary-intervention-for-chronic-total-occlusion
#12
Eisuke Usui, Tetsumin Lee, Tadashi Murai, Yoshihisa Kanaji, Junji Matsuda, Makoto Araki, Taishi Yonetsu, Yosuke Yamakami, Shigeki Kimura, Tsunekazu Kakuta
Specific signatures of culprit lesions detected on multidetector computed tomography (MDCT) were identified as predictors of periprocedural myocardial injury (PMI) after percutaneous coronary intervention (PCI) in patients with stable angina; PMI has been shown to be associated with a worse prognosis. We investigated the association between preprocedural culprit lesion characteristics, assessed by MDCT, and PMI after PCI for chronic total occlusion (CTO). From three medical centers, 81 patients who underwent pre-PCI MDCT and CTO PCI, and systematic cardiac troponin (cTn) sampling before and after PCI, were included...
February 7, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28091872/impact-of-revascularization-of-coronary-chronic-total-occlusion-on-left-ventricular-function-and-electrical-stability-analysis-by-speckle-tracking-echocardiography-and-signal-averaged-electrocardiogram
#13
Yohei Sotomi, Atsunori Okamura, Katsuomi Iwakura, Motoo Date, Hiroyuki Nagai, Tomohiro Yamasaki, Yasushi Koyama, Koichi Inoue, Yasushi Sakata, Kenshi Fujii
The present study aimed to assess the mechanisms of effects of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) from two different aspects: left ventricular (LV) systolic function assessed by two-dimensional speckle tracking echocardiography (2D-STE) and electrical stability evaluated by late potential on signal-averaged electrocardiogram (SAECG). We conducted a prospective observational study with consecutive CTO-PCI patients. 2D-STE and SAECG were performed before PCI, and after 1-day and 3-months of procedure...
January 13, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28089997/the-impact-of-age-and-sex-on-in-hospital-outcomes-of-chronic-total-occlusion-percutaneous-coronary-intervention
#14
Aris Karatasakis, Rahel Iwnetu, Barbara A Danek, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, David E Kandzari, Nicholas J Lembo, Mitul Patel, Ehtisham Mahmud, William L Lombardi, R Michael Wyman, J Aaron Grantham, Anthony H Doing, Catalin Toma, James W Choi, Barry F Uretsky, Jeffrey W Moses, Ajay J Kirtane, Ziad A Ali, Manish Parikh, Judit Karacsonyi, Bavana V Rangan, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: We sought to determine the effect of age and sex on procedural outcomes and efficiency of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We examined the clinical and angiographic characteristics and outcomes of 1675 CTO-PCIs performed in 1644 patients between 2012 and 2016 at 15 United States centers. RESULTS: Mean age was 65.3 ± 10 years and 1408 (86%) were men. Overall technical and procedural success rates were 88% and 87%, respectively...
January 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28066662/-spiral-stenting-creating-a-subintimal-neo-luminal-helix-around-a-massively-calcified-ostial-chronic-total-occlusion-of-the-right-coronary-artery-in-a-patient-with-recurrent-ventricular-tachycardia
#15
Kambis Mashayekhi, Zivile Valuckiene, Hans Neuser, Marlon Walter, Wolfgang Gappmaier, Thomas Kaiser, Franz-Josef Neumann, Ibrahim Akin, Michael Behnes
This case report describes a successful percutaneous coronary intervention (PCI) of a severely calcified aorto-ostial chronic total occlusion (CTO) of the right coronary artery (RCA). The lesion was treated by a retrograde approach implementing long spiral subintimal wire tracking and final coronary stenting creating a subintimal neo-luminal helix around the natively occluded RCA. After 6 months of follow-up valuable angiographic results were proven.
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28044983/chronic-total-occlusion-in-a-non-infarct-related-artery-is-closely-associated-with-increased-five-year-mortality-in-patients-with-st-segment-elevation-acute-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-from-the-credo-kyoto-ami
#16
Hiroki Watanabe, Takeshi Morimoto, Hiroki Shiomi, Yutaka Furukawa, Yoshihisa Nakagawa, Kenji Ando, Kazushige Kadota, Takeshi Kimura
AIMS: We sought to investigate the clinical impact of chronic total occlusion (CTO) in a non-infarct-related artery (IRA) on long-term cardiovascular outcomes in patients with ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS: Among 5,429 patients enrolled in the CREDO-Kyoto AMI registry, the current study population consisted of 2,045 STEMI patients with multivessel disease (MVD) who underwent primary PCI within 24 hours after symptom onset. The cumulative five-year, 30-day and 30-day to five-year incidences of all-cause death were all significantly higher in the CTO group than in the non-CTO group (37...
February 3, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28041697/validity-of-the-j-cto-score-and-the-cl-score-for-predicting-successful-cto-recanalization
#17
J E Guelker, L Bansemir, R Ott, T Rock, K Kroeger, R Guelker, H G Klues, D I Shin, A Bufe
BACKGROUND: Percutaneous coronary intervention (PCI) of total chronic coronary occlusion (CTO) still remains a major challenge in interventional cardiology. To predict the probability of a successful intervention different scoring systems are available. We analyzed in this study the validity of two scoring systems, the Japanese CTO score (J-CTO score) and the newly developed Clinical and Lesion-related score (CL Score). METHODS: Between 2012 and 2015 we included 379 consecutive patients...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28040288/collateral-filling-efficiency-of-comorbid-chronic-total-occlusion-segment-on-short-term-mortality-in-st-elevation-myocardial-infarction
#18
Toshiharu Fujii, Masataka Nakano, Yohei Ohno, Gaku Nakazawa, Norihiko Shinozaki, Takashi Matsukage, Fuminobu Yoshimachi, Yuji Ikari
BACKGROUND: Collateral filling of chronic total occlusion (CTO) segments is considered to affect hemodynamic stability in primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) with CTO, however its value as a prognostic indicator for mortality is uncertain. The present study examined the relationship between collateral filling of CTO segments and short-term mortality in patients with STEMI with a comorbid CTO lesion. METHODS: Among 829 STEMI patients who underwent primary PCI, 74 patients with CTO were identified...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28029214/long-term-outcomes-of-rotational-atherectomy-for-the-percutaneous-treatment-of-chronic-total-occlusions
#19
Lorenzo Azzalini, Rustem Dautov, Soledad Ojeda, Antonio Serra, Susanna Benincasa, Barbara Bellini, Francesco Giannini, Jorge Chavarría, Livia L Gheorghe, Manuel Pan, Mauro Carlino, Antonio Colombo, Stéphane Rinfret
OBJECTIVES: To study the long-term outcomes of rotational atherectomy (RA) for chronic total occlusion (CTO) percutaneous coronary intervention (PCI). BACKGROUND: There is little evidence on the incidence, procedural results and long-term outcomes of RA for CTO PCI. METHODS: This registry included data from consecutive patients undergoing CTO PCI at four specialized centers. Major adverse cardiac events (MACE: cardiac death, target-vessel myocardial infarction and ischemia-driven target-vessel revascularization) on follow-up were the primary endpoint...
December 28, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28004266/long-term-major-adverse-cardiac-and-cerebrovascular-events-macce-rate-comparison-of-retrograde-and-antegrade-recanalization-of-chronic-total-coronary-occlusions
#20
Klaudija Bijuklic, Carsten Schwencke, Joachim Schofer
BACKGROUND: The recanalization success rate of chronic total occlusion (CTO) percutaneous coronary interventions (PCI) can be increased by the retrograde approach; however, the long-term outcome of patients undergoing retrograde procedures is unknown. AIM: We aimed to evaluate the long-term major adverse cardiac and cerebrovascular event (MACCE) rate (e.g. death, myocardial infarction, coronary artery bypass surgery and stroke) in patients after retrograde versus antegrade CTO-PCI...
December 21, 2016: Wiener Klinische Wochenschrift
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