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Chronic coronary occlusion

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https://www.readbyqxmd.com/read/29331435/complications-of-chronic-total-occlusion-percutaneous-coronary-intervention-subepicardial-hematoma
#1
Punag Divanji, Kendrick Shunk
A 67-year-old man with coronary artery disease and previous coronary underwent successful Guideliner reverse CART percutaneous coronary intervention of a chronic total occlusion of the right coronary artery. He later developed evidence of myocardial ischemia, and imaging, including angiogram, echocardiogram, and cardiac computed tomography revealing active dye extravasation from the previously normal RV marginal branches, in addition to a large subepicardial hematoma. Despite these dramatic findings, the patient remained hemodynamically stable and pain-free, with resolving ECG changes...
December 30, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29330258/chronic-total-occlusion-percutaneous-coronary-intervention-evidence-and-controversies
#2
REVIEW
Peter Tajti, Emmanouil S Brilakis
No abstract text is available yet for this article.
January 12, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29315803/short-term-and-long-term-clinical-outcomes-of-rotational-atherectomy-in-resistant-chronic-total-occlusion
#3
Wei-Chieh Huang, Hsin-I Teng, Wan-Leong Chan, Tse-Min Lu
OBJECTIVES: To evaluate the short- and long-term clinical outcomes of RA in CTO coronary intervention. BACKGROUND: The application of rotational atherectomy (RA) may improve the success rate of percutaneous recanalization of chronic total occlusion (CTO) with heavy calcification. METHODS: From January 2011 to September 2014, we enrolled 285 patients with CTO who underwent successful percutaneous coronary intervention (PCI). Resistant CTO lesions were defined as those with heavy calcifications as well as those that no devices are able to pass after guide wire crossing...
January 8, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29314641/chronic-total-occlusion-does-anti-platelet-choice-impact-outcomes
#4
EDITORIAL
Wassim Shatila, Zvonimir Krajcer
Chronic total occlusion (CTO) is associated with worse outcomes compared to non CTO percutaneous coronary intervention (PCI). CTO might be associated with vasomotor dysfunction Ticagrelor is a novel P2Y12 inhibitor that increases local adenosine The TIGER-BVS trial plans to assess the impact of using ticagrelor vs. clopidogrel on vasomotor activity and outcomes after successful CTO PCI.
January 1, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29314567/antegrade-fenestration-and-re-entry-a-new-controlled-subintimal-technique-for-chronic-total-occlusion-recanalization
#5
Mauro Carlino, Lorenzo Azzalini, Satoru Mitomo, Antonio Colombo
OBJECTIVES: To describe and evaluate the efficacy of a novel antegrade dissection/re-entry (ADR) technique, called antegrade fenestration and re-entry (AFR), for chronic total occlusions (CTO) percutaneous coronary intervention (PCI). BACKGROUND: The widespread adoption of ADR is limited by several technical, logistic, and financial factors. Therefore, novel ADR techniques are needed. METHODS: AFR consists in creating multiple fenestrations of the dissection flap separating the false and true lumen...
January 4, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29314563/subadventitial-stenting-around-occluded-stents-a-bailout-technique-to-recanalize-in-stent-chronic-total-occlusions
#6
Lorenzo Azzalini, Aris Karatasakis, James C Spratt, Péter Tajti, Robert F Riley, Luiz F Ybarra, Stefan P Schumacher, Susanna Benincasa, Barbara Bellini, Luciano Candilio, Satoru Mitomo, Peter Henriksen, Francisco Hidalgo, Leo Timmers, Adriaan O Kraaijeveld, Pierfrancesco Agostoni, James Roy, David R Ramsay, James C Weaver, Paul Knaapen, Alexander Nap, Boris Starcevic, Soledad Ojeda, Manuel Pan, Khaldoon Alaswad, William L Lombardi, Mauro Carlino, Emmanouil S Brilakis, Antonio Colombo, Stéphane Rinfret, Kambis Mashayekhi
OBJECTIVES: To evaluate the outcomes of subadventitial stenting (SS) around occluded stents for recanalizing in-stent chronic total occlusions (IS-CTOs). BACKGROUND: There is little evidence on the outcomes of SS for IS-CTO. METHODS: We examined the outcomes of SS for IS-CTO PCI at 14 centers between July 2011 and June 2017, and compared them to historical controls recanalized using within-stent stenting (WSS). Target-vessel failure (TVF) on follow-up was the endpoint of this study, and was defined as a composite of cardiac death, target-vessel myocardial infarction, and target-vessel revascularization...
January 4, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29314289/long-term-outcomes-post-chronic-total-occlusion-intervention-implications-of-completeness-of-revascularization
#7
Pravin K Goel, Roopali Khanna, C M Pandey, Fauzia Ashfaq
BACKGROUND: Long term clinical outcomes post chronic total occlusion (CTO) intervention may depend not only on CTO success/failure alone but also on Completeness of revascularization. OBJECTIVES: To determine long term outcomes post CTO intervention and relate them to both success versus failure and Complete Revascularization (CR) versus Incomplete Revascularization (IR). METHODS: Consecutive patients taken up for CTO intervention with at-least one CTO vessel between Jan 2006 to Dec 2015 were included...
January 4, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29311284/collateral-channel-size-and-tortuosity-predict-retrograde-percutaneous-coronary-intervention-success-for-chronic-total-occlusion
#8
Ching-Chang Huang, Chih-Kuo Lee, Shih-Wei Meng, Chi-Sheng Hung, Ying-Hsien Chen, Mao-Shin Lin, Chih-Fan Yeh, Hsien-Li Kao
BACKGROUND: There is little evidence on how to select an interventional collateral channel (CC) in retrograde chronic total occlusion (CTO) percutaneous coronary intervention. We aimed to identify independent angiographic predictors of CC tracking and technical success in retrograde CTO percutaneous coronary intervention. METHODS AND RESULTS: From January 2012 to December 2015, a total of 216 consecutive retrograde CTO percutaneous coronary intervention attempts by a high-volume operator in a tertiary university-affiliated hospital were enrolled...
January 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29306468/mid-term-outcomes-of-chronic-total-occlusion-percutaneous-coronary-intervention-with-subadventitial-vs-intraplaque-crossing-a-systematic-review-and-meta-analysis
#9
Aris Karatasakis, Barbara A Danek, Judit Karacsonyi, Lorenzo Azzalini, Mauro Carlino, Stéphane Rinfret, Minh Vo, Bavana V Rangan, M N Burke, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: Some reports have demonstrated increased risk with subadventitial chronic total occlusion (CTO) crossing, whereas others suggest equipoise between subadventitial and intraplaque crossing techniques. We sought to clarify the effect of subadventitial lesion crossing on mid-term outcomes of CTO percutaneous coronary intervention (PCI). METHODS: We conducted a systematic review and meta-analysis of studies reporting post-discharge outcomes after CTO PCI performed via subadventitial vs...
February 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29289358/association-of-stress-test-risk-classification-with-health-status-after-chronic-total-occlusion-angioplasty-from-the-outcomes-patient-health-status-and-efficiency-in-chronic-total-occlusion-hybrid-procedures-open-cto-study
#10
Adam C Salisbury, James Sapontis, John T Saxon, Kensey L Gosch, William L Lombardi, Dimitri Karmpaliotis, Jeffery W Moses, Mohammed Qintar, Ajay J Kirtane, John A Spertus, David J Cohen, J Aaron Grantham
Stress testing is endorsed by the American College of Cardiology/American Heart Association Appropriate Use Criteria to identify appropriate candidates for Chronic Total Occlusion (CTO) Percutaneous Coronary Intervention (PCI). However, the relation between stress test risk classification and health status after CTO PCI is not known. We studied 449 patients in the 12-center OPEN CTO registry who underwent stress testing before successful CTO PCI, comparing outcomes of patients with low-risk (LR) versus intermediate to high-risk (IHR) findings...
December 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29275602/-long-term-outcomes-of-implanting-drug-eluting-stents-for-unprotected-left-main-coronary-artery-disease-patients-with-left-ventricular-systolic-dysfunction
#11
Y Pan, Q Qiu, W H Ren, X P Yu, Q Li, X J Ren
Objective: To analyze the clinical characteristics and prognosis of implanting drug-eluting stents (DES) for unprotected left main (ULM) coronary artery disease patients with left ventricular systolic dysfunction (LVSD). Methods: A total of 511 ULM coronary artery disease patients who underwent DES implantation from January 2005 to January 2012 in Department of Cardiology, Beijing Anzhen Hospital were included in the study. Based on left ventricular ejection fraction (LVEF), the patients were divided into three groups: LVEF≤40% (n=104), 41%≤LVEF≤49% (n=137), and LVEF≥50% (n=270)...
December 12, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29237747/coronary-chronic-total-occlusions-time-to-abandon-a-culture-of-therapeutic-nihilism
#12
EDITORIAL
Gabby Elbaz-Greener, Harindra C Wijeysundera
No abstract text is available yet for this article.
December 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29237745/dyspnea-among-patients-with-chronic-total-occlusions-undergoing-percutaneous-coronary-intervention-prevalence-and-predictors-of-improvement
#13
Mohammed Qintar, J Aaron Grantham, James Sapontis, Kensey L Gosch, William Lombardi, Dimitri Karmpaliotis, Jeffery Moses, Adam C Salisbury, David J Cohen, John A Spertus, Suzanne V Arnold
BACKGROUND: Dyspnea is a common angina equivalent that adversely affects quality of life, but its prevalence in patients with chronic total occlusions (CTOs) and predictors of its improvement after CTO percutaneous coronary intervention (PCI) are unknown. We examined the prevalence of dyspnea and predictors of its improvement among patients selected for CTO PCI. METHODS AND RESULTS: In the OPEN CTO registry (Outcomes, Patient health status, and Efficiency iN Chronic Total Occlusion) of 12 US experienced centers, 987 patients undergoing CTO PCI (procedure success 82%) were assessed for dyspnea with the Rose Dyspnea Scale at baseline and 1 month after CTO PCI...
December 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29233197/takayasu-arteritis-in-paediatrics
#14
Marisa Di Santo, Erica V Stelmaszewski, Alejandra Villa
Takayasu arteritis is an idiopathic chronic granulomatous panarteritis predominantly affecting the aorta and its main branches. Although idiopathic, genetic contribution to disease susceptibility is being increasingly recognised. Rare in children, Takayasu arteritis is a worldwide disease with significant morbidity and mortality. Its diagnosis is a challenge and requires awareness of the condition as clinical features at presentation are non-specific and assessing disease activity is difficult. In the inflammatory stage, treatment is essential to prevent the insidious course and vascular damage: stenotic, occlusive lesions, aneurysms, and aortic regurgitation...
December 13, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29224054/lesion-characteristics-and-procedural-outcomes-of-re-attempted-percutaneous-coronary-interventions-for-chronic-total-occlusion
#15
Masaki Tanabe, Kenji Kodama, Kohei Asada, Takeo Kunitomo
This study was performed to investigate lesion characteristics and procedural outcomes of re-attempted percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). Prior failure of percutaneous revascularization of CTO has been identified as an independent predictor of failure at subsequent attempts. However, procedural outcomes of re-attempted PCI for CTO have not been elucidated. We evaluated lesion characteristics and procedural outcomes in 310 consecutive patients undergoing CTO-PCI, and compared the results between re-attempted (n = 59) and initial procedures (n = 251)...
December 9, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29220345/a-randomized-trial-of-bifurcation-stenting-technique-in-chronic-total-occlusions-percutaneous-coronary-intervention
#16
Vitaly I Baystrukov, Evgeniy I Kretov, Marouane Boukhris, Alexander G Osiev, Igor O Grazhdankin, Alexey V Biryukov, Hatem Najjar, Vladimir V Verin, Dmitriy D Zubarev, Ivan A Naryshkin, Alexander V Bogachev-Prokophiev, Kambis Mashayekhi, Alfredo R Galassi, Alexey A Prokhorikhin
BACKGROUND: The optimal strategy to treat bifurcation lesions (BFLs) in a percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) remains unknown. AIMS: We sought to assess whether T-provisional or mini-crush is appropriate for BFLs within CTO vessels. PATIENTS AND METHODS: From January 2011 to December 2013, patients who underwent successful CTO guidewire crossing and with a BFL within the CTO target vessel were enrolled prospectively and assigned randomly to either T-provisional stenting or the mini-crush technique for BFL treatment...
January 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29214718/coronary-artery-disease-revascularization-and-clinical-outcomes-in-transcatheter-aortic-valve-replacement-real-world-results-from-the-east-denmark-heart-registry
#17
Oscar Millan-Iturbe, Fadi J Sawaya, Jacob Lønborg, Danny H F Chow, Gintautas Bieliauskas, Thomas Engstrøm, Lars Søndergaard, Ole De Backer
Transcatheter aortic valve replacement (TAVR) has become an established therapeutic option for patients with symptomatic, severe aortic stenosis. The optimal treatment strategy for concomitant coronary artery disease (CAD) has not been tested prospectively in a randomized clinical trial. This study aimed to describe the degree of CAD, revascularization strategies, and long-term clinical outcomes in a large-scale all-comers TAVR-population. Nine hundred and forty-four consecutive patients underwent TAVR. Obstructive CAD was reported in 224 patients (23...
December 7, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29208580/wire-externalisation-techniques-for-retrograde-percutaneous-coronary-interventions-of-chronic-total-occlusions
#18
Kambis Mashayekhi, Zivile Valuckiene, Hans Neuser, Ibrahim Akin, Nicolaus Reifart, Aurel Toma, Franz-Josef Neumann, Michael Behnes
No abstract text is available yet for this article.
December 8, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29207367/subadventitial-advancement-of-a-mother-and-child-catheter-to-allow-successful-recanalization-of-a-complex-in-stent-chronic-total-occlusion-testing-the-resistance-of-the-adventitia
#19
Luciano Candilio, Satoru Mitomo, Mauro Carlino, Antonio Colombo, Lorenzo Azzalini
In-stent chronic total occlusion (CTO) represents a challenging lesion subset for percutaneous coronary intervention (PCI), and although a true-to-true lumen crossing is the first-line strategy, a subadventitial approach may become necessary. Here we describe a case of successful in-stent right coronary artery CTO-PCI performed with subadventitial crossing, crushing of the occluded stents, and advancement of a mother-and-child catheter to the distal right coronary artery through the subadventitial space to allow stent delivery...
December 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29205158/prognostic-impact-of-non-culprit-chronic-total-occlusions-in-infarct-related-cardiogenic-shock-results-of-the-randomized-iabp-shock-ii-trial
#20
Mohammed Saad, Georg Fuernau, Steffen Desch, Ingo Eitel, Suzanne de Waha, Janine Pöss, Taoufik Ouarrak, Steffen Schneider, Uwe Zeymer, Holger Thiele
AIMS: To investigate the impact of a chronic total occlusion (CTO) in a non-infarct-related coronary artery (non-IRA) on 1-year mortality and occurrence of cardiac arrhythmia in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI). METHODS AND RESULTS: In a retrospective sub-analysis of the Intraaortic Balloon Pump in Cardiogenic Shock II trial (IABP-SHOCK II) and its accompanying registry, 201 (26%) of 761 patients had a CTO in a non-IR major coronary artery...
December 5, 2017: EuroIntervention
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