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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/28792157/optical-coherence-tomography-and-stent-boost-imaging-guided-bioresorbable-vascular-scaffold-overlapping-for-coronary-chronic-total-occlusion-lesion
#5
Hu Li, Seung Woon Rha, Cheol Ung Choi, Dong Joo Oh
We report herein the optical coherence tomography (OCT) and stent boost imaging guided bioresorbable vascular scaffold (BVS) implantation for right coronary artery (RCA) chronic total occlusion (CTO) lesion. The gold standard for evaluating BVS expansion after percutaneous coronary intervention is OCT. However, stent boost imaging is a new technique that improves fluoroscopy-based assessments of stent overlapping, and the present case shows clinical usefulness of OCT and stent boost imaging guided 'overlapping' BVS implantation via antegrade approach for a typical RCA CTO lesion...
September 2017: Yonsei Medical Journal
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
#6
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/28777638/self-focusing-and-the-talbot-effect-in-conformal-transformation-optics
#7
Xiangyang Wang, Huanyang Chen, Hui Liu, Lin Xu, Chong Sheng, Shining Zhu
Transformation optics has been used to propose various novel optical devices. With the help of metamaterials, several intriguing designs, such as invisibility cloaks, have been implemented. However, as the basic units should be much smaller than the working wavelengths to achieve the effective material parameters, and the sizes of devices should be much larger than the wavelengths of illumination to work within the light-ray approximation, it is a big challenge to implement an experimental system that works simultaneously for both geometric optics and wave optics...
July 21, 2017: Physical Review Letters
https://www.readbyqxmd.com/read/28776267/outcomes-of-patients-with-periprocedural-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-for-chronic-total-occlusion
#8
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
#9
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/28766400/transvenous-intravascular-ultrasound-guided-endovascular-treatment-for-chronic-total-occlusion-of-infrainguinal-arteries
#10
Yasuhiro Takahashi, Taisuke Sato, Hirotake Okazaki, Ayaka Nozaki, Masato Matsushita, Masataka Kamiya, Wataru Shimizu
PURPOSE: To investigate the 1-year outcomes of transvenous intravascular ultrasound (IVUS)-guided endovascular therapy (EVT) for chronic total occlusion (CTO) of the lower extremity arteries. METHODS: Transvenous IVUS-guided EVT was performed in 44 patients (50 limbs) with CTO of the femoropopliteal arteries or tibioperoneal trunk. Treatment involved crossing a guidewire through the CTO under the guidance of both fluoroscopic and IVUS imaging, along with insertion of the IVUS catheter into a vein parallel to the target artery...
August 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28760100/the-utility-of-outpatient-commitment-i-a-need-for-treatment-and-a-least-restrictive-alternative-to-psychiatric-hospitalization
#11
Steven P Segal, Stephania L Hayes, Lachlan Rimes
OBJECTIVES: This study examined whether psychiatric patients assigned to community treatment orders (CTOs), outpatient commitment in Victoria, Australia, have a greater need for treatment to protect their health and safety than patients not assigned to CTOs. It also considered whether such treatment is provided in a least restrictive manner-that is, in a way that contributes to reduced use of psychiatric hospitalization. METHODS: The sample included 11,424 patients first placed on a CTO between 2000 and 2010, and 16,161 patients not placed on a CTO...
August 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28760099/the-utility-of-outpatient-commitment-ii-mortality-risk-and-protecting-health-safety-and-quality-of-life
#12
Steven P Segal, Stephania L Hayes, Lachlan Rimes
OBJECTIVE: This study assessed the contribution of a form of outpatient commitment-community treatment orders (CTOs)-to mortality risk and quality of life of patients with severe mental illness. METHODS: Data (2000--2012) were obtained from the Australian National Death Index, Victoria Department of Health, Victoria police records, and National Outcomes and CaseMix Collection quality-of-life records for patients in the Victorian Psychiatric Case Register/RAPID with a history of psychiatric hospitalization: CTO cohort, N=11,424; non-CTO cohort, N=16,161...
August 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28750147/micro-catheter-balloon-pinning-technique-to-facilitate-wiring-of-a-left-circumflex-cto
#13
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
#14
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/28738486/-association-between-collateral-circulation-and-myocardial-viability-evaluated-by-cardiac-magnetic-resonance-imaging-in-patients-with-coronary-artery-chronic-total-occlusion
#15
J N Li, L J Zhang, Y He, Y L Chen, R C Huang, S Z Lyu, X T Song
Objective: Late gadolinium enhancement(LGE) cardiac magnetic resonance imaging(CMR) was used to evaluate the myocardial viability of chronic total occlusion(CTO) in patients with coronary heart disease and to observe the relationship between collateral circulation and myocardium viability in these patients. Methods: This retrospective study included 40 patients with CTO diagnosed by invasive coronary angiography (CAG) from September 2015 to June 2016 in our department, all patients performed CMR examination within one week after CAG...
July 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
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
#16
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
#17
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...
September 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28707447/cto-revascularization-obstacles-and-options-in-balloon-nonpenetrable-lesions
#18
EDITORIAL
On Topaz
CTO lesions resisting balloon crossing are located in moderate/severe tortuous coronary arteries contain more moderate/severe calcification burden and carry a higher J-CTO score as compared with balloon crossable CTO lesions. CTO lesions resisting balloon crossing do not constitute a homogenous group. In 25% of the patients, the resisting CTO was caused by stent restenosis and thrombus is an integral component of CTO in addition to calcium and fibrosis. The excimer laser and rotational/orbital atherectomy are among useful debulking technologies capable of creating a "pilot recanalization channel" in the CTO that enables completion of the revasularization...
July 2017: Catheterization and Cardiovascular Interventions
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
#19
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/28707308/baseline-anemia-in-patients-undergoing-percutaneous-coronary-intervention-after-an-acute-coronary-syndrome-a-paradox-of-high-bleeding-risk-high-ischemic-risk-and-complex-coronary-disease
#20
Khaled Yazji, Fairoz Abdul, Senthil Elangovan, Muhammad Z Ul Haq, Nick Ossei-Gerning, Keith Morris, Richard Anderson, Tim Kinnaird
OBJECTIVES: To define more clearly the associations between baseline anemia, bleeding/ischemia risk, coronary disease severity, and outcomes by revascularization completeness. BACKGROUND: Anemia is associated with adverse outcomes in patients presenting with an acute coronary syndrome (ACS). METHODS AND RESULTS: Data was sourced from hospital databases for patients admitted with an ACS to a single center between 2011 and 2014. Using WHO anemia criteria, 468 (26...
July 13, 2017: Journal of Interventional Cardiology
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