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CTO PCI

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https://www.readbyqxmd.com/read/27910082/impact-of-the-presence-of-chronically-occluded-coronary-artery-on-long-term-prognosis-of-patients-with-acute-st-segment-elevation-myocardial-infarction
#1
Maciej Lesiak, Monika Cugowska, Aleksander Araszkiewicz, Marek Grygier, Małgorzata Pyda, Włodzimierz Skorupski, Przemysław Mitkowski, Magdalena Łanocha, Stefan Grajek
BACKGROUND: Multivessel disease (MVD) is a significant risk factor in patients with acute ST-segment elevation myocardial infarction (STEMI). Whether the presence of chronic total occlusion (CTO) poses an additional hazard is still unknown. The objective of this study was to evaluate the impact of CTO on survival in STEMI patients. METHODS: The study group consisted of 836 STEMI patients treated with primary percutaneous coronary intervention (PCI). MVD was diagnosed in 52...
December 2, 2016: Cardiology Journal
https://www.readbyqxmd.com/read/27890863/the-first-clinical-experience-with-a-novel-locking-microcatheter-in-chronic-coronary-total-occlusions
#2
Simon J Wilson, Joren Maeremans, Simon J Walsh, Colm G Hanratty, Markus Meyer-Gessner, Jo Dens, Evald H Christiansen, Alexander Bufe, James C Spratt
AIMS: A novel 'locking' microcatheter has been developed to address residual failure modes in chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The aim of this study was to report the first clinical experience of this device. METHODS AND RESULTS: The microcatheter was assessed prospectively in 92 unselected CTO cases across 6 European sites. Overall technical success was 85.9% (79/92) and 97.5% for patients with a J- CTO score of <3 (39/40)...
November 29, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27890859/long-term-outcome-of-patients-with-chronic-total-coronary-occlusion-treated-by-percutaneous-coronary-intervention-in-diabetics-and-non-diabetics
#3
Francesca Sanguineti, Philippe Garot, Stephen O'Connor, Yusuke Watanabe, Marco Spaziano, Thierry Lefèvre, Thomas Hovasse, Hakim Benamer, Thierry Unterseeh, Bernard Chevalier, Marie Claude Morice, Yves Louvard
AIMS: Despite technical advancements, long-term outcomes after Chronic Total Occlusion (CTO) recanalization remain a subject of debate, especially in diabetic patients. METHODS AND RESULTS: Between 2004 and 2012, 1,320 consecutive patients underwent PCI for CTO, 27.4 % (362/1320) of whom were diabetics. We compared cardiac death, target lesion revascularisation (TLR), myocardial infarction (MI) and combined Myocardial Adverse Cardiac Events (MACE) in patients with successful versus failed PCI (median follow up 4...
November 29, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27888750/medium-platelet-volume-as-a-noninvasive-predictor-of-chronic-total-occlusion-in-non-infarct-artery-in-patients-with-non-st-segment-elevation-myocardial-infarction-and-multivessel-coronary-artery-disease
#4
Mateusz Tajstra, Michał Hawranek, Piotr Desperak, Aneta Ciślak, Marek Gierlotka, Andrzej Lekston, Lech Poloński, Mariusz Gąsior
BACKGROUND: Chronic total occlusion (CTO) in a noninfarct-related artery (non-IRA) is an independent predictor of mortality in non-ST elevation myocardial infarction (NSTEMI). Mean platelet volume (MPV) is associated with cardiovascular events in NSTEMI. Little is known about the predictors of non-IRA-CTO in patients with NSTEMI. The purpose of this study was to evaluate the relationship between the presence of non-IRA-CTO with MPV level in patients with NSTEMI and multivessel coronary artery disease (MVCAD)...
November 14, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27887799/procedural-and-longer-term-outcomes-of-wire-versus-device-based-antegrade-dissection-and-re-entry-techniques-for-the-percutaneous-revascularization-of-coronary-chronic-total-occlusions
#5
Lorenzo Azzalini, Rustem Dautov, Emmanouil S Brilakis, Soledad Ojeda, Susanna Benincasa, Barbara Bellini, Aris Karatasakis, Jorge Chavarría, Bavana V Rangan, Manuel Pan, Mauro Carlino, Antonio Colombo, Stéphane Rinfret
BACKGROUND: There are few data regarding the procedural and follow-up outcomes of different antegrade dissection/re-entry (ADR) techniques for chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We compiled a multicenter registry of consecutive patients undergoing ADR-based CTO PCI at four high-volume specialized institutions. Patients were divided according to the specific ADR technique used: subintimal tracking and re-entry (STAR), limited antegrade subintimal tracking (LAST), or device-based with the CrossBoss/Stingray system (Boston Scientific, Marlborough, MA)...
November 16, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27867143/survival-after-percutaneous-coronary-intervention-for-chronic-total-occlusion-in-elderly-patients
#6
Aurel Toma, Catherine Gebhard, Michael Gick, Ademaj Fadil, Barbara E Stähli, Kambis Mashayekhi, Miroslaw Ferenc, Franz-Josef Neumann, Heinz Joachim Buettner
AIMS: Few data are available on outcomes of percutaneous coronary intervention (PCI) for coronary chronic total occlusions (CTO) in very elderly patients in the drug-eluting stent (DES) era. We investigated long-term survival in a single-center cohort of elderly patients following CTO PCI using DES. METHODS AND RESULTS: Consecutive 2002 patients who underwent PCI of a CTO at our center between 01/2005 and 12/2013 were followed for a median of 2.6 years (interquartile range 1...
November 22, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27860111/coronary-artery-spatial-distribution-of-chronic-total-occlusions-insights-from-a-large-us-registry
#7
Santiago Garcia, M Chadi Alraies, Aris Karatasakis, Demetris Yannopoulos, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul P Patel, John Bahadorani, Judit Karacsonyi, Pratik Kalsaria, Barbara Danek, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVE: To assess the spatial distribution of chronic total occlusions (CTOs) within the coronary arteries and describe procedural strategies and outcomes during CTO percutaneous coronary intervention (PCI). BACKGROUND: Acute occlusions due to plaque rupture tend to cluster within the proximal third of the coronary artery. METHODS: We examined the clinical and procedural characteristics of 1,348 patients according to lesion location within the coronary tree...
November 10, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27855293/efficient-distal-tip-size-of-primary-guidewire-for-antegrade-percutaneous-coronary-intervention-in-chronic-total-occlusion-the-g-force-study
#8
Yuji Ikari, Masaki Awata, Kazuaki Mitsudo, Takashi Akasaka, Shigeru Saito, Takayuki Ishihara, Toshiharu Fujii, Hideki Hashimoto, Mitsuyasu Terashima, Tomokazu Ikemoto, Kiyoshi Hibi, Junichi Tazaki, Akihiro Nakamura, Hideo Nishikawa, Tadaya Sato, Yoshihisa Nakagawa
BACKGROUND: Although several new techniques have been introduced for CTO such as the retrograde approach, the fundamental question of what type of guidewire is the most appropriate as a primary guidewire in the antegrade approach has not been answered. METHODS: The G-FORCE study was designed as a prospective multicenter randomized controlled trial to determine the efficient primary guidewire in antegrade approach for chronic total occlusion (CTO). The first guidewire was randomly assigned to a regular size distal tip group (0...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27845873/periprocedural-myocardial-injury-after-recanalization-of-single-chronic-coronary-occlusion-a-propensity-score-analysis-comparing-long-term-clinical-outcomes
#9
Milosz Jaguszewski, Natasza Gilis-Malinowska, Juan Luis Gutierrez-Chico, Michal Chmielecki, Pawel Skarzynski, Slawomir Burakowski, Piotr Drewla, Radoslaw Targonski, Lukasz Lewicki, Witold Dubaniewicz, Marcin Fijalkowski, Marcin Gruchala, Dariusz Ciecwierz
BACKGROUND: Rates and importance of periprocedural myocardial injury (PMI) after crossing coronary chronic total occlusions (CTOs) is not well understood. This study sought to investigate long-term clinical implications of PMI in patients undergoing percutaneous coronary intervention (PCI) for single CTO utilizing antegrade technique. METHODS: Out of 11,957 patients undergoing non-urgent PCI, a total of 1110 patients with symptomatic angina and single CTO were treated by antegrade PCI and observed for up to 10 years...
November 15, 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27845507/updates-on-radial-approach-for-percutaneous-coronary-intervention-in-patients-with-chronic-total-occlusion
#10
Lazzaro Paraggio, Francesco Burzotta, Cristina Aurigemma, Carlo Trani
INTRODUCTION: Radial approach is the emerging arterial access for percutaneous coronary interventions (PCIs) in patients with coronary artery disease. EVIDENCE ACQUISITION: Among the different subset of complex targets for PCI, chronic total occlusion (CTO) still represent a challenge for the interventional cardiologist. Is radial approach suitable for PCI on CTO? A series of data collected in selected centres with high volume of transradial procedures supported the change from elective transfemoral approach to systematic transradial approach...
November 15, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27836292/impact-of-coronary-collateral-circulation-on-angiographic-in-stent-restenosis-in-patients-with-stable-coronary-artery-disease-and-chronic-total-occlusion
#11
Zhen Kun Yang, Ying Shen, Jian Hu, Qi Zhang, Feng Hua Ding, Rui Yan Zhang, Lin Lu, Wei Feng Shen
OBJECTIVE: This study aimed to evaluate the relationship between coronary collateralization and in-stent restenosis (ISR) in stable coronary artery disease patients with chronic total occlusion (CTO) after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation. METHODS: The degree of coronary collaterals supplying the distal aspect of a total occlusion from the contra-lateral vessel was graded according to Rentrop classification in 216 patients with stable angina undergoing successful DES based PCI for CTO...
November 2, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27832848/determinants-and-prognostic-significance-of-periprocedural-myocardial-injury-in-patients-with-successful-percutaneous-chronic-total-occlusion-interventions
#12
Seung-Whan Lee, Pil H Lee, Se H Kang, Hanul Choi, Mineok Chang, Jae-Hyung Roh, Sung-Han Yoon, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
OBJECTIVES: This study sought to evaluate the determinants and prognostic implications of periprocedural myocardial injury (PMI) in successful percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs). BACKGROUND: There are limited studies addressing the risk factors and clinical implication of PMI in patients undergoing CTO-PCI. METHODS: We examined 1,058 consecutive CTO patients who underwent successful drug-eluting stent implantation and serial measurements of creatine kinase-myocardial band (CK-MB) values between March 2003 and August 2014...
November 14, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27817847/-chronic-total-occlusions-is-there-a-woman-specificity
#13
F Sanguineti, C Garcia-Alonso, H Benamer, G J Karrillon
Many differences have been reported regarding gender in angioplasty procedures (PCI), but their potential influence on clinical outcomes after CTO PCI has not been elucidated. Aim of this paper is to analyse these potential differences starting from 2 clinical cases. The basic features found in the two clinical cases presented here, older age and presence of diabetes (that are more frequent in women), are in line with the differences identified in non-CTO studies on angioplasty. Furthermore, CTO in women are generally under-diagnosed and less frequently treated by angioplasty than in men...
November 3, 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27814739/benefits-of-chronic-total-coronary-occlusion-percutaneous-intervention-in-patients-with-heart-failure-and-reduced-ejection-fraction-insights-from-a-cardiovascular-magnetic-resonance-study
#14
Montserrat Cardona, Victoria Martín, Susanna Prat-Gonzalez, José Tomás Ortiz, Rosario Jesús Perea, Teresa Maria de Caralt, Mónica Masotti, Félix Pérez-Villa, Manel Sabaté
BACKGROUND: Chronic total occlusion percutaneous coronary intervention (CTO-PCI) can improve angina and left ventricular ejection fraction (LVEF). These benefits were not assessed in populations with heart failure with reduced ejection fraction (HFrEF). We studied the effect of CTO-PCI on left ventricular function and clinical parameters in patients with HFrEF. METHODS: Using cardiovascular magnetic resonance (CMR), we studied 29 patients with HFrEF and evidence of viability and/or ischemia in the territory supplied by a CTO who were successfully treated with CTO-PCI...
November 5, 2016: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/27802929/safety-and-effectiveness-of-the-surfing-technique-to-cross-septal-collateral-channels-during-retrograde-chronic-total-occlusion-percutaneous-coronary-intervention
#15
Rustem Dautov, Marina Urena, Can Manh Nguyen, Claire Gibrat, Stéphane Rinfret
AIMS: Septal surfing and distal tip injections are two techniques used for septal crossing in retrograde chronic total occlusion (CTO) percutaneous coronary interventions (PCI). We examined for the first time the safety and feasibility of the septal surfing technique. METHODS AND RESULTS: Among 470 consecutive CTO PCIs performed between 01/2010 and 12/2015, 240 (51%) involved a retrograde attempt. In the septal crossing subgroup, we evaluated if the Werner collateral channel (CC) classification, CTO location, tortuosity, and number of large septal CCs influenced retrograde crossing success, time, perforation...
November 2, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27788851/the-hybrid-algorithm-for-treating-chronic%C3%A2-total-occlusions-in-europe-the-recharge-registry
#16
Joren Maeremans, Simon Walsh, Paul Knaapen, James C Spratt, Alexandre Avran, Colm G Hanratty, Benjamin Faurie, Pierfrancesco Agostoni, Erwan Bressollette, Peter Kayaert, Alan J Bagnall, Mohaned Egred, Dave Smith, Alexander Chase, Margaret B McEntegart, William H T Smith, Alun Harcombe, Paul Kelly, John Irving, Elliot J Smith, Julian W Strange, Joseph Dens
BACKGROUND: The hybrid algorithm for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) was developed to improve procedural outcomes. Large, prospective studies validating the algorithm in a broad multicenter setting with operators of different experience levels are lacking. OBJECTIVES: The RECHARGE (REgistry of Crossboss and Hybrid procedures in FrAnce, the NetheRlands, BelGium and UnitEd Kingdom) registry aims to report achievable results using the hybrid algorithm...
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27773418/complications-encountered-in-coronary-chronic-total-occlusion-intervention-prevention-and-bailout
#17
REVIEW
Debabrata Dash
Despite the continuing developments of improved medical devices and increasing operator expertize, coronary chronic total occlusion (CTO) remains as one of the most challenging lesion subsets in interventional cardiology. Percutaneous coronary intervention (PCI) of CTO is a complex procedure carrying the risk of complications that are responsible for significant morbidity and mortality. The complications can be classified as coronary (such as coronary occlusion, perforation, device embolization, or entrapment); cardiac non-coronary (such as periprocedural myocardial infarction); extra cardiac (such as vascular access complications, systemic embolization, contrast-induced nephropathy, and radiation-induced injury)...
September 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27759734/contemporary-techniques-for-coronary-cto-revascularization-an-update
#18
Vladimir Dedovic, Goran Stankovic
Despite permanent improvement in success rate and technical developments, chronic total occlusion (CTO) remains undertreated by percutaneous coronary intervention (PCI). Dedicated CTO operators from Japan, Europe and USA perform these procedures with success rate beyond 90%, but there is still huge gap between this group of specialists and broader population of PCI operators. Recently proposed CTO scores can be used for patients' selection according to the CTO operators' experience. Patients with low CTO score values may be suitable for less experienced operators at the beginning of the CTO PCI learning curve, while more complex CTOs (higher CTO score values) should be differed to CTO experts...
October 19, 2016: Panminerva Medica
https://www.readbyqxmd.com/read/27755015/the-outcomes-patient-health-status-and-efficiency-in-chronic-total-occlusion-hybrid-procedures-registry-rationale-and-design
#19
James Sapontis, Steven P Marso, David J Cohen, William Lombardi, Dimitri Karmpaliotis, Jeffrey Moses, William J Nicholson, Ashish Pershad, R Michael Wyman, Anthony Spaedy, Stephen Cook, Parag Doshi, Robert Federici, Craig R Thompson, Karen Nugent, Kensey Gosch, John A Spertus, J Aaron Grantham
BACKGROUND: Patients with chronic total occlusions of a coronary artery represent a complex, yet common, clinical conundrum among patients with ischemic heart disease. Chronic total occlusion angioplasty is increasingly being used as a treatment for these complex lesions. There is a compelling need to better quantify the safety, efficacy, benefits, and costs of the procedure. METHODS: To address these gaps in knowledge, we designed the Outcomes, Patient Health Status, and Efficiency IN Chronic Total Occlusion Hybrid Procedures (OPEN CTO) study, an investigator-initiated multicenter, single-arm registry including 12 centers with a planned enrollment of 1000 patients...
October 13, 2016: Coronary Artery Disease
https://www.readbyqxmd.com/read/27741138/application-of-a-snare-technique-in-retrograde-chronic-total-occlusion-percutaneous-coronary-intervention-a-step-by-step-practical-approach-and-an-observational-study
#20
Hsiu-Yu Fang, Wei-Chieh Lee, Chih-Yuan Fang, Chiung-Jen Wu
Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) has recently become popular among interventional cardiologists. CTO originating from the ostium has been one of the most difficult CTO lesions to treat with PCI for a number of reasons. Our aim was to illustrate a specific technique during retrograde CTO PCI referred to as the "snare technique."We retrospectively examined the use of "snare technique" among 371 consecutive retrograde CTO PCIs performed at our institution between 2006 and 2015...
October 2016: Medicine (Baltimore)
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