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https://www.readbyqxmd.com/read/28803800/-ping-pong-technique-for-treating-a-balloon-uncrossable-chronic-total-occlusion
#1
Michael Koutouzis, Grigorios Avdikos, Georgios Nikitas, Theodoros Zografos, Ioannis Tsiafoutis, Maria Agelaki, Efstathios Lazaris
Balloon uncrossable lesions are a well-known challenge during chronic total occlusion (CTO) interventions. The technique of using two different catheters into the same coronary artery, the so-called "ping-pong" technique, is a technique described for treating complications during percutaneous coronary intervention (PCI), like perforations or rotational atherectomy burr entrapment. We describe a case where the "ping-pong" technique was successfully used to facilitate treatment of a balloon uncrossable CTO lesion...
July 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28797429/early-procedural-and-health-status-outcomes-after-chronic-total-occlusion%C3%A2-angioplasty-a-report-from-the-open-cto-registry-outcomes-patient-health-status-and-efficiency-in-chronic-total-occlusion-hybrid-procedures
#2
James Sapontis, Adam C Salisbury, Robert W Yeh, David J Cohen, Taishi Hirai, William Lombardi, James M McCabe, Dimitri Karmpaliotis, Jeffrey Moses, William J Nicholson, Ashish Pershad, R Michael Wyman, Anthony Spaedy, Stephen Cook, Parag Doshi, Robert Federici, Craig R Thompson, Steven P Marso, Karen Nugent, Kensey Gosch, John A Spertus, J Aaron Grantham
OBJECTIVES: This study sought to accurately describe the success rate, risks, and patient-reported benefits of contemporary chronic total occlusion (CTO) percutaneous coronary intervention (PCI). BACKGROUND: In light of the evolving techniques to successfully revascularize CTO lesions, there remains a compelling need to more accurately quantify the success rates, risks, and benefits of these complex procedures. METHODS: Using a uniquely comprehensive, core-lab adjudicated, single-arm, multicenter registry of 1,000 consecutive patients undergoing CTO PCI by the hybrid approach, we evaluated the technical success rates, complication rates, and raw and adjusted health status benefits at 1 month among successfully as compared to unsuccessfully treated patients...
August 14, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28797424/retrograde-chronic-total-occlusion-percutaneous-coronary-intervention-through-ipsilateral-collateral-channels-a-multicenter-registry
#3
Lorenzo Azzalini, Pierfrancesco Agostoni, Susanna Benincasa, Paul Knaapen, Stefan P Schumacher, Joseph Dens, Joren Maeremans, Adriaan O Kraaijeveld, Leo Timmers, Michael Behnes, Ibrahim Akin, Aurel Toma, Franz-Josef Neumann, Antonio Colombo, Mauro Carlino, Kambis Mashayekhi
OBJECTIVES: The aim of this study was to describe the procedural aspects and outcomes of retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) through ipsilateral collateral channels (ILCs). BACKGROUND: Retrograde CTO PCI via ILCs is rarely performed, usually when no other retrograde options exist, and available evidence derives mostly from case reports. METHODS: A large retrospective multinational registry was compiled, including all consecutive patients undergoing retrograde CTO PCI through ILCs at 6 centers between September 2011 and October 2016...
August 14, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28795482/coronary-dominance-and-prognosis-in-patients-with-chronic-total-occlusion-treated-with-percutaneous-coronary-intervention
#4
Cathérine Gebhard, Michael Gick, Miroslaw Ferenc, Barbara E Stähli, Fadil Ademaj, Kambis Mashayekhi, Heinz Joachim Buettner, Franz-Josef Neumann, Aurel Toma
AIM: The prognostic value of coronary artery dominance pattern in patients with chronic total occlusions (CTO) is unknown. The aim of this study was to assess the influence of coronary vessel dominance on short and long-term outcomes in patients undergoing percutaneous coronary intervention (PCI) for CTO. METHODS AND RESULTS: Our study population consisted of 2002 consecutive patients (17% females, mean age 65.2 ± 10.7 years) who underwent PCI of at least one coronary CTO lesion at our center between 01/2005 and 12/2013...
August 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28789842/impact-of-target-vessel-on-long-term-cardiac-mortality-after-successful-chronic-total-occlusion-percutaneous-coronary-intervention-insights-from-a-japanese-multicenter-registry
#5
Satoru Mitomo, Toru Naganuma, Richard J Jabbour, Katsumasa Sato, Hideo Takebayashi, Tsuyoshi Kobayashi, Jun-Ei Obata, Kenji Sakamoto, Kenichi Tsujita, Kiyotaka Kugiyama, Hisao Ogawa, Sunao Nakamura
BACKGROUND: The impact of successful chronic total occlusion (S-CTO) percutaneous coronary intervention (PCI) on cardiac mortality may differ depending on target CTO vessel; however, to date this has not yet been adequately evaluated. The aim of this study was to investigate the impact of target vessel on cardiac mortality after S-CTO PCI. METHODS: From January 2004 to December 2011, 1517 CTO PCIs were performed in 4 Japanese centers and enrolled in a multicenter registry...
August 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28776267/outcomes-of-patients-with-periprocedural-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-for-chronic-total-occlusion
#6
Barbara E Stähli, Cathérine Gebhard, Michael Gick, Kambis Mashayekhi, Miroslaw Ferenc, Heinz Joachim Buettner, Franz-Josef Neumann, Aurel Toma
BACKGROUND: Successful CTO recanalization has been associated with clinical benefit. Outcomes of patients with atrial fibrillation undergoing CTO PCI have not been investigated, yet. AIMS: This study sought to evaluate the association between atrial fibrillation and outcomes after percutaneous coronary intervention (PCI) for chronic total occlusions (CTO). METHODS: Consecutive patients undergoing CTO PCI between January 2005 and December 2013 were divided into patients with and without atrial fibrillation, and propensity-matched models used to adjust for baseline differences between groups...
August 3, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28766879/bivalirudin-in-percutaneous-coronary-intervention-for-chronic-total-occlusion-a-single-center-pilot-study
#7
Chenguang Li, Rende Xu, Yi Shen, Yuxiang Dai, Feng Zhang, Jianying Ma, Lei Ge, Juying Qian, Junbo Ge
BACKGROUND: Bivalirudin has been reported to be an alternative to unfractionated heparin (UFH) for anticoagulation during percutaneous coronary intervention (PCI) and associated with less bleeding risk. However, the feasibility of bivalirudin during PCI of chronic total occlusion lesions (CTO) remains unknown. OBJECTIVE: To evaluate the efficacy and safety of bivalirudin versus UFH in CTO PCI. METHODS: In this prospective and randomized controlled trial in single center, CTO patients with high bleeding risk were randomized to treatment with bivalirudin (bolus 0...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28750147/micro-catheter-balloon-pinning-technique-to-facilitate-wiring-of-a-left-circumflex-cto
#8
Kevin N Oguayo, Chris C Oguayo, Ravi Vallabhan, James W Choi
INTRODUCTION: Coronary chronic total occlusions (CTOs) are commonly encountered during diagnostic angiograms. With recent advances, especially in experienced centers, success rates with CTO percutaneous coronary intervention (PCI) have approached 80% or higher. It is important to note that despite these advancements in techniques, CTOs remain difficult to treat. We present a case of a left circumflex artery (LCX) CTO that was successfully revascularized using a microcatheter balloon pinning technique that allowed additional wire support...
July 27, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28741573/novel-radiation-dose-reduction-fluoroscopic-technology-facilitates-chronic-total-occlusion-percutaneous-coronary-interventions
#9
Stephen Balter, Matthew Brinkman, Sanjog Kalra, Tamim Nazif, Manish Parikh, Ajay J Kirtane, Jeffrey Moses, Martin B Leon, Angeli Feri, Philip Green, Ziad A Ali, Ming Liao, Dimitrios Karmpaliotis
AIMS: Radiation exposure and prolonged procedure time continue to limit the complexity of CTO-PCI procedures attempted. This study aimed assess the impact of radiation-dose-limiting equipment on radiation dosage and fluoroscopic time in chronic total occlusion (CTO) percutaneous coronary interventions (PCI). METHODS AND RESULTS: Retrospective clinical and dosimetric data from diagnostic catheterizations (DXC) and CTO-PCI procedures performed on one of three variants of interventional fluoroscopic equipment were collected...
July 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28724418/improved-recovery-of-regional-left-ventricular-function-after-pci-of-chronic-total-occlusion-in-stemi-patients-a-cardiovascular-magnetic-resonance-study-of-the-randomized-controlled-explore-trial
#10
Joëlle Elias, Ivo M van Dongen, Loes P Hoebers, Dagmar M Ouweneel, Bimmer E P M Claessen, Truls Råmunddal, Peep Laanmets, Erlend Eriksen, René J van der Schaaf, Dan Ioanes, Robin Nijveldt, Jan G Tijssen, Alexander Hirsch, José P S Henriques
BACKGROUND: The Evaluating Xience and left ventricular function in PCI on occlusiOns afteR STEMI (EXPLORE) trial did not show a significant benefit of percutaneous coronary intervention (PCI) of the concurrent chronic total occlusion (CTO) in ST-segment elevation myocardial infarction (STEMI) patients on global left ventricular (LV) systolic function. However a possible treatment effect will be most pronounced in the CTO territory. Therefore, we aimed to study the effect of CTO PCI compared to no-CTO PCI on the recovery of regional LV function, particularly in the CTO territory...
July 19, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28716335/management-of-chronic-total-coronary-occlusion-in-stable-ischemic-heart-disease-by-percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-versus-medical-therapy
#11
Mony Shuvy, Feng Qiu, Alyssandra Chee-A-Tow, John J Graham, Wael Abuzeid, Christopher Buller, Bradley H Strauss, Harindra C Wijeysundera
Coronary chronic total occlusions (CTOs) are found in approximately 20% of angiograms. We sought to assess the variation in the management of patients with CTOs and to compare the clinical outcomes of CTO lesions with those of non-CTO lesions. We conducted a population-based cohort study and included all patients with stable angina who underwent cardiac catheterization from October 1, 2012, to June 30, 2013, in Ontario, Canada. The primary outcome was a composite of mortality and hospitalization for myocardial infarction...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28707316/ticagrelor-and-absorb-bioresorbable-vascular-scaffold-implantation-for-recovery-of-vascular-function-after-successful-chronic-total-occlusion-recanalization-tiger-bvs-trial-rationale-and-study-design
#12
Salvatore Brugaletta, Josep Gomez-Lara, Juan Caballero, Luis Ortega-Paz, Luis Teruel, Miriam Jimenez Fernandez, Rafael Romaguera, Vicente Alcalde Martinez, Marcos Ñato, Eduardo Molina Navarro, Joan-Antoni Gomez-Hospital, Concepcion Correa Vilches, Maria Joyera, Angel Cequier, Manel Sabate
OBJECTIVES: To explore the role of ticagrelor versus clopidogrel in coronary blood flow normalization immediately after chronic coronary total occlusion (CTO) recanalization. BACKGROUND: Coronary vascular function of a CTO immediately after recanalization is demonstrated to be poor. METHODS: The TIGER BVS is a prospective, double-randomized, open-label, two parallel-group controlled clinical trial to evaluate efficacy of ticagrelor versus clopidogrel in improving vascular function of coronary segment distal to CTO immediately after CTO recanalization...
July 14, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28705045/percutaneous-coronary-interventions-of-chronic-total-occlusions-a-review-of-clinical-indications-treatment-strategy-and-current-practice
#13
Johan Bennett, Peter Kayaert, Yoann Bataille, Jo Dens
Chronic total occlusions (CTOs) are commonly encountered in patients undergoing coronary angiography, but percutaneous coronary intervention (PCI) for CTO is currently infrequently performed owing to the perception of limited clinical benefit, high complexity and cost of intervention, and perceived risk of complications. Numerous observational studies have demonstrated that successful CTO revascularization is associated with better cardiovascular outcomes and enhanced quality of life (QOL). However, in the absence of randomized trials, its prognostic benefit remains debated...
July 14, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28692460/coronary-intervention-for-chronic-total-occlusion-current-indications-and-future-directions
#14
Janarthanan Sathananthan, Vladimír Džavík
Chronic total occlusions (CTOs) are routinely encountered during coronary angiography, but subsequent revascularization rates are low. This has likely been driven by a historical belief that there is minimal clinical benefit and poor success rates with a percutaneous coronary intervention (PCI). However, in the current era, with the development of new techniques and tools, experienced operators can perform CTO-PCI successfully in the majority of patients. The current indications and benefit of CTO-PCI remain a topic of controversy and debate...
August 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28648437/utility-of-adjunctive-modalities-in-coronary-chronic-total-occlusion-intervention
#15
REVIEW
Hemal Bhatt, Sean Janzer, Jon C George
Coronary chronic total occlusion (CTO) intervention remains one of the most challenging domains in interventional cardiology. Due to the technical challenges involved and potential procedural complications, CTO percutaneous coronary intervention (PCI) attempt and success rates remain less than standard PCI. However, the use of several adjunctive tools such as intravascular ultrasound, optical coherence tomography, rotational atherectomy, orbital atherectomy, excimer laser coronary atherectomy and percutaneous left ventricular assist device may contribute to improved CTO PCI success rates or provide better hemodynamic assessment of CTO lesion (i...
May 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28624404/accuracy-of-j-cto-score-derived-from%C3%A2-computed-tomography-versus-angiography-to-predict-successful-percutaneous-coronary-intervention
#16
Akiko Fujino, Satoru Otsuji, Katsuyuki Hasegawa, Toyohiro Arita, Shin Takiuchi, Kenichi Fujii, Masanori Yabuki, Motoaki Ibuki, Shinya Nagayama, Kasumi Ishibuchi, Toshikazu Kashiyama, Rui Ishii, Hiroto Tamaru, Wataru Yamamoto, Masahiko Hara, Yorihiko Higashino
OBJECTIVES: The aim of this study was to compare the ability of conventional versus computed tomography angiography (CTA) to predict procedural success and 30-min wire crossing rates in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions. BACKGROUND: Coronary CTA can be used to assess the morphology of CTO lesions. METHODS: We examined 205 consecutive patients (218 CTO lesions) who underwent coronary CTA pre-PCI...
June 14, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28616560/successful-revascularization-improves-long-term-clinical-outcome-in-patients-with-chronic-coronary-total-occlusion
#17
Tomohiko Teramoto, Etsuo Tsuchikane, Masanori Yamamoto, Hitoshi Matsuo, Yoshiaki Kawase, Yoriyasu Suzuki, Seiji Kanou, Tetsurou Shimura, Hirotomo Sato, Maoto Habara, Kenya Nasu, Masashi Kimura, Yoshihisa Kinoshita, Mitsuyasu Terashima, Tetsuo Matsubara, Takahiko Suzuki
BACKGROUND: Following the development of breakthrough techniques for percutaneous coronary intervention (PCI) in the treatment of chronic total occlusions (CTO), the initial success rate of PCI in CTO lesions (CTO-PCI) has improved; however, there are few reports regarding the effects of successful CTO revascularization on long-term mortality in Japan. The aim of this study was to compare the long-term clinical outcomes of patients with successful versus failed CTO recanalization and to identify related factors...
March 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28612905/treatment-of-coronary-chronic-total-occlusion-by-transradial-approach-current-trends-and-expert-recommendations
#18
Leszek Bryniarski, Michał Zabojszcz, Krzysztof Leszek Bryniarski
The aim of this review is to highlight the technical details and the scientific data on percutaneous coronary interventions (PCIs) in chronic total occlusion (CTO) performed by transradial approach (TRA). Transfemoral approach (TFA) is commonly regarded as the standard for CTO PCI, but there are a growing number of CTO recanalization procedures performed by TRA. We discuss the relevant technical details to approach a CTO by transradial access, especially the compatibility of various CTO recanalization techniques with specific guiding catheter sizes...
June 14, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28595880/predictive-scores-of-success-in-cto-pci-there-is-no-substitute-for-operator-experience-and-skill
#19
EDITORIAL
Nicholas J Lembo, Raja Hatem, Dimitri Karmpaliotis
No abstract text is available yet for this article.
June 12, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28588825/a-presentation-of-postcardiac-injury-syndrome-after-successful-chronic-total-occlusion-percutaneous-coronary-intervention-using-dissection-re-entry-techniques
#20
Gabby Elbaz-Greener, Harindra C Wijeysundera
Retrograde dissection re-entry can cause pericardial trauma of sufficient degree to lead to the development of an auto-immune postpericardial injury syndrome. Clinical suspicion for this condition should be high in the event of fever, symptoms, pericardial/pleural effusion, and pleuritic chest pain following chronic total occlusion (CTO) Post cardiac injury syndromes (PCI).
June 2017: Clinical Case Reports
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