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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
#1
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
#2
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
#3
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/28515407/comparison-of-the-outback-%C3%A2-elite-reentry-catheter-and-the-bi-directional-approach-after-failed-antegrade-approach-for-femoro-popliteal-occlusive-disease
#4
Daizo Kawasaki, Masashi Fukunaga, Tsuyoshi Nakata, Masaaki Kato, Nobukazu Ohkubo
AIM: A successful antegrade wire crossing for femoro-popliteal chronic total occlusion (FP-CTO) is still a technical challenge. We attempted to demonstrate the safety and feasibility of the OUTBACK(®) Elite reentry catheter and the bi-directional approach for failed FP-CTO cases with the antegrade approach. METHODS: Endovascular therapy for FP-CTO was performed in 219 lesions from May 2013 to December 2016 at Morinomiya Hospital. We retrospectively analyzed the data of 43 consecutive lesions which underwent endovascular therapy using the bi-directional approach with distal access and the mono-directional approach with the OUTBACK(®) Elite reentry catheter for FP-CTO lesions...
May 17, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/28512069/optical-coherence-tomography-findings-insights-from-the-randomised-multicentre-trial-investigating-angiographic-outcomes-of-hybrid-sirolimus-eluting-stents-with-biodegradable-polymer-compared-with-everolimus-eluting-stents-with-durable-polymer-in-chronic-total
#5
Koen Teeuwen, Eva M Spoormans, Johan Bennett, Christophe Dubois, Walter Desmet, Giovanni J Ughi, Ann Belmans, Johannes C Kelder, Jan G P Tijssen, Pierfrancesco Agostoni, Maarten J Suttorp, Tom Adriaenssens
AIMS: The PRISON IV trial investigated the next-generation sirolimus-eluting stent (SES) with ultra-thin struts and biodegradable polymer against the second-generation everolimus-eluting stent (EES) with thin struts and durable polymer in patients with successfully recanalised chronic total occlusions (CTO). In this study, we examined the secondary optical coherence tomography endpoints. METHODS AND RESULTS: The main PRISON IV trial randomised 330 patients to either SES or EES...
May 18, 2017: EuroIntervention
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
#6
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
#7
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
#8
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/28488411/improved-equipment-used-by-knowledgeable-operators-does-reduce-radiation
#9
EDITORIAL
Stephen Balter
Improvements in fluoroscopic equipment design and configuration facilitates radiation reduction. Operators should exploit improved equipment and fully apply procedural radiation management techniques. Less radiation did not impair the success rate of treating complex CTO lesions.
May 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28486842/impact-of-angioscopic-evaluation-for-femoropopliteal-in-stent-restenosis-before-and-after-excimer-laser-atherectomy
#10
Akiko Idemoto, Naotaka Okamoto, Akihiro Tanaka, Naoki Mori, Daisuke Nakamura, Masamichi Yano, Nobuhiko Makino, Yasuyuki Egami, Ryu Shutta, Jun Tanouchi, Masami Nishino
In-stent restenosis (ISR) is a prevalent problem following stenting of femoropopliteal lesions. A potential novel treatment modality for ISR including excimer laser atherectomy (ELA) has become available. We performed ELA for in-stent chronic total occlusion (CTO) of femoropopliteal lesions and evaluated lesion morphology before and after ELA by angioscopy in 2 patients. The angioscopic findings clearly showed removal of in-stent thrombi after ELA. Thus, ELA may be effective for in-stent CTO of femoropopliteal lesions...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28484274/monocytic-microrna-profile-associated-with-coronary-collateral-artery-function-in-chronic-total-occlusion-patients
#11
Nazanin Hakimzadeh, Joëlle Elias, Gilbert W M Wijntjens, Ruud Theunissen, Angela van Weert, Martijn W Smulders, Nynke van den Akker, Perry D Moerland, Hein J Verberne, Loes P Hoebers, Jose P S Henriques, Anja M van der Laan, Mustafa Ilhan, Mark Post, Sebastiaan C A M Bekkers, Jan J Piek
An expansive collateral artery network is correlated with improved survival in case of adverse cardiac episodes. We aimed to identify cellular microRNAs (miRNA; miR) important for collateral artery growth. Chronic total occlusion (CTO) patients (n = 26) were dichotomized using pressure-derived collateral flow index (CFIp) measurements; high collateral capacity (CFIp > 0.39; n = 14) and low collateral (CFIp < 0.39; n = 12) capacity. MiRNA profiling via next generation sequencing from various monocyte phenotypes (freshly isolated monocytes, monocytes cultured without stimulant, or stimulation with lipopolysaccharide, interleukin 4, transforming growth factor beta-1, or interferon gamma) revealed significantly different miRNA expression patterns between high versus low collateral capacity patients...
May 8, 2017: Scientific Reports
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
#12
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
#13
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
#14
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/28473110/impact-of-chronic-total-coronary-occlusion-on-recurrence-of-ventricular-arrhythmias-in-ischemic-secondary-prevention-implantable-cardioverter-defibrillator-recipients-vacto-secondary-study-insights-from-coronary-angiogram-and-electrogram-analysis
#15
Luis Nombela-Franco, Mario Iannaccone, Ignasi Anguera, Ignacio J Amat-Santos, Manuel Sanchez-Garcia, Daniel Bautista, Martin N Calvelo, Andrea Di Marco, Claudio Moretti, Roberto Pozzi, Marco Scaglione, Victoria Cañadas, María Sandin-Fuentes, Angel Arenal, Rodrigo Bagur, Nicasio Perez-Castellano, Cristina Fernandez-Perez, Fiorenzo Gaita, Carlos Macaya, Javier Escaned, Ignacio Fernández-Lozano
OBJECTIVES: This study sought to evaluate the incidence and clinical effect of coronary chronic total occlusions (CTOs) in patients with ischemic cardiomyopathy receiving an implantable cardioverter-defibrillator (ICD) for secondary prevention of sudden cardiac death (SCD). BACKGROUND: CTOs are common in patients with ischemic cardiomyopathy, which is the major cause of SCD. However, the impact of CTO in SCD survivors receiving an ICD is unknown. METHODS: A total of 425 patients who had survived an episode of ventricular arrhythmias and underwent ICD implantation for secondary prevention in 8 centers were included...
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
#16
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
#17
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
#18
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/28460777/unraveling-the-mystique-of-cto-interventions-tips-and-techniques-of-using-hardware-to-achieve-success
#19
EDITORIAL
Sundeep Mishra
The scientific discourse of chronic total occlusions interventions is mired in a technical jargon so confusing that it prevents an average interventional cardiologist from pursuing this field so much so that it has become a domain of a few. This review attempts to simplify this vernacular and present it in a manner that this procedure comes within the scope of a mainstream interventionist.
March 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28457200/simultaneous-antegrade-retrograde-subintimal-revascularization-of-a-femoropopliteal-chronic-total-occlusion-by-a-reentry-device-facilitated-puncture-of-a-retrogradely-inserted-balloon
#20
Jan Peter Goltz, Susanne Anton, Marcus Wiedner, Jörg Barkhausen, Erik Stahlberg
PURPOSE: To report a rendezvous technique for subintimal revascularization of a chronic total occlusion (CTO) of the superficial femoral artery (SFA). TECHNIQUE: This maneuver is appropriate after failure to cross a long SFA CTO via intra- and subintimal approaches from the ipsilateral femoral as well as retrograde posterior tibial artery (PTA) access sites. After predilation of the subintimal space from the femoral access, a reentry device was placed at the level of the first popliteal artery segment...
April 1, 2017: Journal of Endovascular Therapy
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