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CTO PCI

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https://www.readbyqxmd.com/read/28539570/usefulness-and-safety-of-a-novel-modification-of-the-retrograde-approach-for-the-long-tortuous-chronic-total-occlusion-of-coronary-arteries
#1
Zehan Huang, Bin Zhang, Weilu Chai, Dunliang Ma, Hongtao Liao, Zhian Zhong, Feng Wang, Jingye Lin
The aim of this study was to evaluate the feasibility and efficacy of the Guidezilla guide extension catheter in a reverse controlled antegrade and retrograde subintimal tracking (CART) technique for chronic total occlusion (CTO) recanalization.We retrospectively collected 80 CTO cases using reverse CART technology from January 2015 to October 2015 and 20 CTO cases using Guidezilla reverse-CART technology from October 2015 to March 2016. Guidezilla was applied in cases when it was difficult to advance a retro-guidewire through an occlusion segment into the antegrade guide catheter...
May 23, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28521919/intravascular-ultrasound-analysis-of-intraplaque-versus-subintimal-tracking-in-percutaneous-intervention-for-coronary-chronic-total-occlusions-and-association-with-procedural-outcomes
#2
Lei Song, Akiko Maehara, Matthew T Finn, Sanjog Kalra, Jeffrey W Moses, Manish A Parikh, Ajay J Kirtane, Michael B Collins, Tamim M Nazif, Khady N Fall, Raja Hatem, Ming Liao, Tiffany Kim, Philip Green, Ziad A Ali, Candido Batres, Martin B Leon, Gary S Mintz, Dimitri Karmpaliotis
OBJECTIVES: Using intravascular ultrasound (IVUS), the authors compared outcomes by observed wire position (intraplaque vs. subintimal) achieved during successful chronic total occlusion (CTO) lesion treatment. BACKGROUND: Recent successes in CTO percutaneous coronary intervention (PCI) have used both intraluminal and subintimal wire tracking to improve procedural success. IVUS may be used to determine the course of wire tracking after crossing a CTO. METHODS: From March 2014 to March 2016, data were collected into a single-center database from 219 patients undergoing CTO PCI with concomitant IVUS imaging...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28516401/endovascular-crossing-of-chronic-total-occlusions-using-an-impulse-an-explorative-design-study
#3
Aimée Sakes, Marleen van der Wiel, Dimitra Dodou, Paul Breedveld
In this study we investigated whether exerting an impulse on a Chronic Total Occlusion (CTO) improves the success rate of CTO crossing as compared to the currently used method of statically pushing the guidewire against the CTO. A prototype (Ø2 mm) was developed that generates translational momentum using a spring-loaded indenter and converts it to an impulse during impact. Mechanical performance was evaluated by measuring the peak force and momentum for different spring compressions and strike distances in air and blood-mimicking fluid...
May 17, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28515854/determinants-of-percutaneous-coronary-intervention-success-in-repeat-chronic-total-occlusion-procedures-following-an-initial-failed-attempt
#4
Cecilia Cuevas, Nicola Ryan, Alicia Quirós, Juan Gustavo Del Angel, Nieves Gonzalo, Pablo Salinas, Pilar Jiménez-Quevedo, Luis Nombela-Franco, Ivan Nuñez-Gil, Antonio Fernandez-Ortiz, Carlos Macaya, Javier Escaned
AIM: To investigate the rates and determinants of success of repeat percutaneous coronary intervention (PCI) following an initial failed attempt at recanalising the chronic total occlusions (CTO) percutaneously. METHODS: In 445 consecutive first attempt CTO-PCI procedures in our institution, procedural failure occurred in 149 (33.5%). Sixty-four re-PCI procedures were performed in 58 patients (39%) all had a single CTO. Procedural and outcome data in the re-PCI population was entered into the institutional database...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28500138/legacy-effect-of-coronary-perforation-complicating-percutaneous-coronary-intervention-for-chronic-total-occlusive-disease-an-analysis-of-26-807-cases-from-the-british-cardiovascular-intervention-society-database
#5
Tim Kinnaird, Richard Anderson, Nicholas Ossei-Gerning, James Cockburn, Alex Sirker, Peter Ludman, Mark deBelder, Simon Walsh, Elliot Smith, Colm Hanratty, James Spratt, Julian Strange, David Hildick-Smith, Mamas A Mamas
BACKGROUND: Coronary perforation (CP) during chronic total occlusion percutaneous coronary intervention for stable angina (CTO-PCI) is a rare but serious event. The evidence base is limited, and the long-term effects are unclear. Using a national PCI database, the incidence, predictors, and outcomes of CP during CTO-PCI were defined. METHODS AND RESULTS: Data analyzed from the British Cardiovascular Intervention Society data set on all CTO-PCI procedures performed in England and Wales between 2006 and 2013...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28499595/impact-of-calcium-on-chronic-total-occlusion-percutaneous-coronary-interventions
#6
Judit Karacsonyi, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, Ehtisham Mahmud, William Lombardi, Michael R Wyman, Anthony Doing, Jeffrey W Moses, Ajay Kirtane, Manish Parikh, Ziad Ali, David Kandzari, Nicholas Lembo, Santiago Garcia, Barbara A Danek, Aris Karatasakis, Erica Resendes, Pratik Kalsaria, Bavana V Rangan, Imre Ungi, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
We sought to examine the impact of calcific deposits on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The outcomes of 1,476 consecutive CTO PCIs performed in 1,453 patients (65.5 ± 10 years, 85% male) between 2012 and 2016 at 11 US centers were evaluated. Moderate or severe quantity of calcium was present in 58% of target lesions. Calcified lesions were more tortuous and more likely to have proximal cap ambiguity and interventional collaterals. PCI of moderately/severely calcified CTOs more often required use of the retrograde approach (54% vs 30%, p <0...
April 13, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28488413/preventing-and-treating-coronary-perforations-lessons-from-disaster-management
#7
EDITORIAL
Yader Sandoval, Emmanouil S Brilakis
Coronary artery perforations (CAP) are rare in patients undergoing routine PCI with recent contemporary databases reporting an incidence ∼0.3%. Older age, cardiomyopathy or left ventricular dysfunction, mechanical circulatory support prior to PCI, and CTO lesions have the strongest association with CAP. Prevention, early detection, preparedness and familiarity with the equipment used to treat perforations (such as efficient use of covered stents, and fat or coil embolization) and regrouping to examine and educate about these experiences are key for improving our response to cath lab disasters...
May 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28476438/controlled-antegrade-intimal-tracking-with-subintimal-balloon-inflation-as-a-novel-bailout-technique-for-chronic-total-occlusion-after-failed-intravascular-ultrasound-guided-parallel-wire-technique
#8
Yuta Imai, Junji Yajima, Fumitaka Hosaka
Failure to cross with a guidewire is the most common reason for failure of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). In cases of CTO PCI with no interventional collaterals, an intravascular ultrasound (IVUS)-guided parallel wire technique is usually the last-resort procedure. Failure of this technique sometimes causes enlarged subintimal space, resulting in procedure failure. We present a successful second attempt at left anterior descending artery CTO PCI with no interventional collaterals...
April 24, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28475584/duration-of-dual-antiplatelet-therapy-in-patients-treated-with-percutaneous-coronary-intervention-for-coronary-chronic-total-occlusion
#9
Seung Hwa Lee, Jeong Hoon Yang, Seung-Hyuk Choi, Taek Kyu Park, Woo Jin Jang, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Hyeon-Cheol Gwon
BACKGROUND: The duration of dual antiplatelet therapy (DAPT) after drug-eluting stent implantation in coronary chronic total occlusion (CTO) remains unclear. METHODS: We retrospectively analyzed a total of 512 patients treated with percutaneous coronary intervention (PCI) in the Samsung Medical Center CTO registry. Patients were separated into ≤ 12-month (199, 38.9%) vs. > 12 month (313, 61.1%) based on DAPT duration with aspirin and clopidogrel. The primary outcome was major adverse cardiac and cerebrovascular event (MACCE) during follow-up...
2017: PloS One
https://www.readbyqxmd.com/read/28473112/impact-of-collateral-circulation-on-survival-in-st-segment-elevation-myocardial-infarction-patients-undergoing-primary-percutaneous-coronary-intervention-with-a-concomitant-chronic-total-occlusion
#10
Joëlle Elias, Loes P C Hoebers, Ivo M van Dongen, Bimmer E P M Claessen, José P S Henriques
OBJECTIVES: This study sought to compare long-term clinical outcome in ST-segment elevation myocardial infarction (STEMI) patients with a concomitant chronic total occlusion (CTO) with well-developed versus poorly developed collaterals toward the CTO. BACKGROUND: In STEMI patients, presence of a CTO is associated with increased morbidity and mortality. CTOs are often (partially) perfused by collateral vessels. Therefore, when the infarct-related artery (IRA) is the main donor vessel for the collateral blood supply of the CTO, infarct size may increase significantly...
May 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28473108/contemporary-incidence-management-and%C3%A2-long-term-outcomes-of-percutaneous%C3%A2-coronary-interventions-for-chronic%C3%A2-coronary-artery-total-occlusions-insights-from-the-va-cart%C3%A2-program
#11
Thomas T Tsai, Maggie A Stanislawski, Kendrick A Shunk, Ehrin J Armstrong, Gary K Grunwald, Alan H Schob, Javier A Valle, Carlos E Alfonso, Brahmajee K Nallamothu, P Michael Ho, John S Rumsfeld, Emmanouil S Brilakis
OBJECTIVES: The aim of this study was to describe the contemporary incidence of chronic total occlusions (CTOs) and the success rates of CTO percutaneous coronary intervention (PCI), as well as the complications and long-term outcomes of these patients. BACKGROUND: The contemporary prevalence and management of coronary CTOs is understudied. METHODS: Consecutive veterans undergoing coronary angiography at 79 Veterans Affairs sites between 2007 and 2013 were examined...
May 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28471074/towards-a-contemporary-comprehensive-scoring-system-for-determining-technical-outcomes-of-hybrid-percutaneous-chronic-total-occlusion-treatment-the-recharge-score
#12
Joren Maeremans, James C Spratt, Paul Knaapen, Simon Walsh, Pierfrancesco Agostoni, William Wilson, Alexandre Avran, Benjamin Faurie, Erwan Bressollette, Peter Kayaert, Alan J Bagnall, Dave Smith, Margaret B McEntegart, William H T Smith, Paul Kelly, John Irving, Elliot J Smith, Julian W Strange, Jo Dens
OBJECTIVES: This study sought to create a contemporary scoring tool to predict technical outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) from patients treated by hybrid operators with differing experience levels. BACKGROUND: Current scoring systems need regular updating to cope with the positive evolutions regarding materials, techniques, and outcomes, while at the same time being applicable for a broad range of operators. METHODS: Clinical and angiographic characteristics from 880 CTO-PCIs included in the REgistry of CrossBoss and Hybrid procedures in FrAnce, the NetheRlands, BelGium and UnitEd Kingdom (RECHARGE) were analyzed by using a derivation and validation set (2:1 ratio)...
May 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28471001/the-inherent-catastrophic-traps-in-retrograde-cto-pci
#13
Eugene B Wu, Etsuo Tsuchikane
When we learn to drive, our driving instructor tells us how to check the side mirror and turn your head to check the blind spot before changing lanes. He tells us how to stop at stop signs, how to drive in slippery conditions, the safe stopping distances, and these all make our driving safe. Similarly, when we learn PCI, our mentors teach us to seat the guiding catheter co-axially, to wire the vessel safely, to deliver balloon and stents over the wire, to watch the pressure of the guiding, in order that we perform PCI safely and evade complications...
May 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28456700/respect-the-septal-perforator-septal-artery-perforation-during-cto-pci-resulting-in-massive-interventricular-septal%C3%A2-hematoma-and-biventricular-cardiac-obstructive-shock
#14
Tiberio M Frisoli, Majed Afana, Sagger Mawri, Mazen Hadid, Luay Sayed, William W O'Neill, Sachin Parikh, Dee Dee Wang, Akshay Khandelwal, Khaldoon Alaswad
No abstract text is available yet for this article.
April 21, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28434645/comparison-of-outcomes-in-men-versus-women-after-percutaneous-coronary-intervention-for-chronic-total-occlusion
#15
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
#16
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
#17
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
#18
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
#19
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...
May 8, 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
#20
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
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