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Chronic total occlusion

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https://www.readbyqxmd.com/read/28944620/intracoronary-snaring-of-the-retrograde-guidewire-how-to-overcome-extreme-takeoff-angles-in-chronic-total-occlusion-percutaneous-coronary-intervention
#1
Lorenzo Azzalini, Luciano Candilio, Mauro Carlino, Antonio Colombo
Extreme angulation of coronary artery takeoff represents a challenge for wiring and device advancement in percutaneous coronary intervention (PCI). This anatomic feature is particularly adverse in cases of chronic total occlusion (CTO) of the ostial-proximal segment of the target vessel. In this setting, the retrograde approach can help getting access to the occlusion. However, difficulties might arise at the critical step of wire externalization, due to the need to overcome the extreme ostial angle. Here, we describe a case of successful CTO PCI of the proximal circumflex artery, which presented an extreme angle at its takeoff...
September 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28943496/clinical-implications-of-periprocedural-myocardial-injury-in-patients-undergoing-percutaneous-coronary-intervention-for-chronic-total-occlusion-role-of-antegrade-and-retrograde-crossing-techniques
#2
Aurel Toma, Barbara Stähli, Cathérine Gebhard, Michael Gick, Jan Minners, Kambis Mashayekhi, Alexandre Avran, Miroslaw Ferenc, Heinz Joachim Buettner, Franz-Josef Neumann
AIMS: Periprocedural myocardial injury (PMI) is frequently observed afterpercutaneous coronary interventions (PCI) for chronic total occlusion (CTO). Weinvestigated the prognostic impact of PMI with the antegrade or the retrogradecrossing technique. METHODS AND RESULTS: A total of 1'909 patients undergoing CTO PCI were stratifiedaccording to the presence/absence of PMI (elevation of cardiac troponin T [cTnT] >5x 99th percentile of normal), and divided according to tertiles of the difference betweenpeak and baseline cTnT within 24 hours (ΔcTnT)...
September 26, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28940388/prognostic-value-of-the-age-creatinine-and-ejection-fraction-score-for-non-infarct-related-chronic-total-occlusion-revascularization-after-primary-percutaneous-intervention-in-acute-st-elevation-myocardial-infarction-patients-a-retrospective-study
#3
Jie Deng, Xiaozeng Wang, Yana Shi, Xin Zhao, Yaling Han
OBJECTIVE: It is not known if ACEF scores could evaluate the prognosis of recanalization of non-infarct-related coronary arteries (non-IRA) with chronic total occlusions (CTO) in patients who successfully underwent primary PCI. The objective of the current study was to assess the prognostic value of ACEF scores in acute ST-segment elevation myocardial infarction (STEMI) patients with non-IRA CTO after successful primary PCI. METHODS: There were 2952 STEMI patients who underwent successful primary PCI from January 2006 to December 2014 in our hospital, among them 377 patients had a non-IRA CTO lesion...
September 20, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28939719/clinical-characteristics-and-management-of-coronary-artery-perforations-a-single-center-11-year-experience-and-practical-overview
#4
Miguel E Lemmert, Rutger J van Bommel, Roberto Diletti, Jeroen M Wilschut, Peter P de Jaegere, F Zijlstra, Joost Daemen, Nicolas M Van Mieghem
BACKGROUND: Coronary artery perforation (CAP) is a potentially lethal complication of percutaneous coronary intervention. We report on the incidence, clinical characteristics, and management of iatrogenic coronary perforations based on an 11-year single-center experience. METHODS AND RESULTS: From February 9, 2005, through November 20, 2016, 150 CAP cases were identified from our percutaneous coronary intervention database of 21 212 procedures (0.71%). Mean age of CAP patients was 66±11 years, and 62...
September 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28938238/impact-of-diabetes-mellitus-on-5-year-clinical-outcomes-in-patients-with-chronic-total-occlusion-lesions
#5
Ahmed Mashaly, Seung-Woon Rha, Byoung Geol Choi, Man Jong Baek, Yang Gi Ryu, Se Yeon Choi, Jae Kyeong Byun, Hu Li, Min Suk Shim, Won Young Jang, Woohyeun Kim, Jun Hyuk Kang, Eun Jin Park, Jah Yeon Choi, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh
BACKGROUND: Diabetes mellitus (DM) is a major predictor of cardiovascular morbidity and mortality. However, there are limited data on the impact of DM in patients who have chronic total occlusion (CTO) lesion on long-term outcomes. PATIENTS AND METHODS: A total of 822 CTO patients who underwent coronary angiography, treated by either percutaneous coronary intervention or optimal medical therapy, were enrolled and divided into two groups: (i) diabetic group (n=363) and (ii) nondiabetic group (n=459)...
September 21, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28932360/very-late-bioresorbable-scaffold-thrombosis-and-reoccurrence-of-dissection-two-years-later-chronic-total-occlusion-recanalization-of-the-left-anterior-descending-artery
#6
Luigi Di Serafino, Plinio Cirillo, Tullio Niglio, Francesco Borgia, Bruno Trimarco, Giovanni Esposito, Eugenio Stabile
We describe the case of a patient presenting with ST-segment elevation myocardial infarction due to very late scaffold thrombosis. The patient was already admitted for an elective percutaneous recanalization of a chronically occluded left anterior descending artery (LAD). The procedure was performed according the sub-intimal tracking and re-entry (STAR) technique with 4 bioresorbable vascular scaffolds implantation. However, even though the coronary flow was preserved at the end of the procedure, the dissected segment was only partially sealed at the distal segment of the LAD...
August 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28930077/bioresorbable-vascular-scaffold-in-chronic-total-occlusions
#7
Jiang Ming Fam, Roberto Diletti
No abstract text is available yet for this article.
September 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28930076/bioresorbable-vascular-scaffold-in-chronic-total-occlusions
#8
Antoine Gerbay, Karl Isaaz
No abstract text is available yet for this article.
September 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28929594/epicardial-collateral-channel-for-retrograded-recanalization-of-chronic-total-occlusion-percutaneous-coronary-intervention-predictors-of-failure-and-procedural-outcome
#9
Zehan Huang, Dunliang Ma, Bin Zhang, Aba A Folson, Jingye Lin, Kaize Wu, Hongtao Liao, Zhian Zhong
OBJECTIVES: This study set out to identify significant lesion features of chronic total occlusion (CTO) that predict successful retrograde recanalization via epicardial collateral channels (CCs). BACKGROUND: Epicardial CCs remain essential in retrograde percutaneous coronary intervention (PCI) of CTO. However, the unpredictability of success and occurrence of complications limit the application of epicardial CCs for retrograde PCI technique for CTO. METHODS: 103 retro-recanalization cases were analyzed using epicardial CCs with successful recanalization as an end point...
September 19, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28928622/central-perforation-of-atretic-pulmonary-valve-using-coronary-microcatheter
#10
Saurabh Kumar Gupta, Rajnish Juneja, Anita Saxena
Percutaneous perforation of pulmonary valve, using 0.014" guidewires meant for coronary artery chronic total occlusion (CTO), is increasingly being performed for select cases of pulmonary atresia with intact ventricular septum (PA-IVS). Despite growing experience, procedural failures and complications are not uncommon. Even in infants treated successfully, the orifice created in the atretic pulmonary valve is eccentric. In this report, we present usefulness of coronary microcatheter in alignment of perforating coronary guidewire to the center of atretic pulmonary valve resulting in central perforation...
September 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28924344/the-return-of-the-vulnerable-plaque-optical-coherence-tomography-imaging-of-a-case-of-a-late-in-stent-restenotic-chronic-total-occlusion
#11
Dilbahar S Mohar, Pranav M Patel, Alisha K Grewal, Prabhsimran Mohar, Morton J Kern
Although the use of drug-eluting stents (DES) has dramatically decreased the incidence of in-stent restenosis (ISR), concerns regarding the late manifestations of ISR remain. Optical coherence tomography (OCT) imaging provides unique insights into characteristics and patterns of ISR. We report a case of late DES ISR with unusual heterogeneous intracoronary luminal characteristics suggestive of vulnerable atherosclerotic plaque activity by OCT imaging. This case demonstrates that late ISR after DES may involve more than mere neointimal hyperplasia with lesion-associated craters, septae, and neoatherosclerosis...
September 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28917556/increased-risk-of-ventricular-arrhythmias-in-survivors-of-out-of-hospital-cardiac-arrest-with-chronic-total-coronary-occlusion
#12
Sing-Chien Yap, Rafi Sakhi, Dominic Amj Theuns, Yunus E Yasar, Rohit E Bhagwandien, Roberto Diletti, Felix Zijlstra, Tamas Szili-Torok
BACKGROUND: A chronic total occlusion (CTO) is common in out-of-hospital cardiac arrest (OHCA) survivors with coronary artery disease. It is unclear whether a CTO contributes to ventricular arrhythmias in this population. OBJECTIVE: This study sought to evaluate the impact of unrevascularized CTO's on the occurrence of appropriate implantable cardioverter-defibrillator (ICD) therapy and all-cause mortality in OHCA survivors with coronary artery disease. METHODS: This was a retrospective study that included all consecutive OHCA survivors with coronary artery disease who received an ICD from 1999 until 2015...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28903939/percutaneous-coronary-intervention-versus-optimal-medical-therapy-for-chronic-total-coronary-occlusion-with-well-developed-collaterals
#13
Se Yeon Choi, Byoung Geol Choi, Seung-Woon Rha, Man Jong Baek, Yang Gi Ryu, Yoonjee Park, Jae Kyeong Byun, Minsuk Shim, Hu Li, Ahmed Mashaly, Won Young Jang, Woohyeun Kim, Jah Yeon Choi, Eun Jin Park, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh
BACKGROUND: The impact of percutaneous coronary intervention (PCI) on chronic total occlusion in patients with well-developed collaterals is not clear. METHODS AND RESULTS: A total of 640 chronic total occlusion patients with collateral flow grade ≥2 were divided into 2 groups; chronic total occlusion patients either treated with PCI (the PCI group; n=305) or optimal medical therapy (the optimal medical therapy group; n=335). To adjust for potential confounders, a propensity score matching analysis was performed...
September 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28898259/association-between-retinal-vein-occlusion-and-an-increased-risk-of-acute-myocardial-infarction-a-nationwide-population-based-follow-up-study
#14
Yu-Yen Chen, Shwu-Jiuan Sheu, Hsiao-Yun Hu, Dachen Chu, Pesus Chou
OBJECTIVE: To investigate a possible association between retinal vein occlusion (RVO) and an increased risk of developing acute myocardial infarction (AMI). DESIGN: A population-based retrospective cohort study using the entire population of the Taiwan National Health Insurance Research Database (NHIRD) from 1st January, 2001 to 31st December, 2013. METHODS: A total of 37921 subjects with RVO were enrolled in the RVO group, and 113763 subjects without RVO were enrolled in the comparison group...
2017: PloS One
https://www.readbyqxmd.com/read/28895475/delayed-intranasal-infusion-of-human-amnion-epithelial-cells-improves-white-matter-maturation-after-asphyxia-in-preterm-fetal-sheep
#15
Lotte G van den Heuij, Mhoyra Fraser, Suzanne L Miller, Graham Jenkin, Euan M Wallace, Joanne O Davidson, Christopher A Lear, Rebecca Lim, Guido Wassink, Alistair J Gunn, Laura Bennet
Perinatal hypoxic-ischemic (HI) brain injury remains highly associated with neurodevelopmental disability after preterm birth. There is increasing evidence that disability is linked with impaired white matter maturation, but there is no specific treatment. In this study, we evaluated whether, in preterm fetal sheep, delayed intranasal infusion of human amnion epithelial cells (hAECs) given 1, 3 and 10 days after severe HI, induced by umbilical cord occlusion for 25 min, can restore white matter maturation or reduce delayed cell loss...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28889135/acute-outcome-of-chronic-total-occlusion-cto-recanalizsation-in-the-elderly
#16
J E Guelker, T Rock, R Ott, M Katoh, K Kroeger, R Guelker, H G Klues, D I Shin, A Bufe
OBJECTIVES: Percutaneous coronary intervention (PCI) of total chronic total occlusion (CTO) still remains a major challenge in interventional cardiology. There is only insignificant knowledge reported in the literature about age differences in CTO recanalization. We analyzed in this study the issue of the impact of age on procedural characteristics, complications and short-term outcome. METHODS: Between 2012-2016 we included 440 patients. They underwent PCI for at least one CTO...
August 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28887249/chronic-nonatherosclerotic-occlusive-popliteal-artery-disease
#17
Jun Gyo Gwon, Yong-Jae Kwon, Young Jin Han, Yong-Pil Cho, Tae-Won Kwon
BACKGROUND: The outcomes of revascularization of nonatherosclerotic occlusive popliteal artery disease are unknown. Therefore, the objective of this study was to analyze the outcomes of recanalization of nonatherosclerotic occlusive popliteal artery disease, the results of which would be useful in creating surgical strategies for such cases. METHODS: From January 2000 to December 2015, a total of 22 patients with nonatherosclerotic occlusive popliteal artery disease underwent open surgical repair...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28885394/pleiotrophin-levels-are-associated-with-improved-coronary-collateral-circulation
#18
Pinar Türker Duyuler, Serkan Duyuler, Murat Gök, Harun Kundi, Canan Topçuoğlu, Ümit Güray
OBJECTIVES: Elucidation of the underlying mechanisms of angiogenesis and arteriogenesis in coronary collateral formation is necessary for new therapies. Pleiotrophin is a secreted multifunctional cytokine and associated with the formation of functional cardiovascular neovascularization in a series of experimental animal models. We aimed to evaluate the serum levels of pleiotrophin in patients with chronic total coronary artery occlusion and poor or good collateral development. METHODS: We included 88 consecutive patients (mean age of the entire population: 63...
September 6, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28867125/comparison-of-benefit-of-successful-percutaneous-coronary-intervention-for-chronic-total-occlusion-in-patients-with-versus-without-reduced-%C3%A2-40-left-ventricular-ejection-fraction
#19
Aurel Toma, Barbara E Stähli, Michael Gick, Catherine Gebhard, Beat A Kaufmann, Kambis Mashayekhi, Miroslaw Ferenc, Heinz Joachim Buettner, Franz-Josef Neumann
Successful recanalization of chronic total occlusions (CTO) has been associated with improved survival. Data on outcomes in patients with left ventricular (LV) systolic dysfunction undergoing percutaneous coronary intervention for CTO, however, are scarce. Between January 2005 and December 2013, a total of 2,002 consecutive patients undergoing elective CTO percutaneous coronary intervention at a tertiary care center were divided into patients with (LV ejection fraction ≤ 40%) and without (LV ejection fraction > 40%) LV systolic dysfunction as defined by transthoracic echocardiography...
August 8, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28866670/clinical-outcome-for-congenital-diaphragmatic-hernia-at-the-age-of-1-year-in-the-era-of-fetal-intervention
#20
Eva Van Ginderdeuren, Karel Allegaert, Herbert Decaluwe, Jan Deprest, Anne Debeer, Marijke Proesmans
BACKGROUND: Congenital diaphragmatic hernia (CDH) is an abnormal development of the diaphragm leading to high neonatal mortality and morbidity. Beyond the neonatal period, prospective data on overall long-term outcome in CDH survivors is scarce. In particular, for those treated with fetoscopic endoluminal tracheal occlusion (FETO), a promising new technique to increase survival chances for severe cases, the outcomes are even less documented. AIM: To prospectively document the clinical outcome of CDH at 1 year including FETO-treated infants in relation to ante- and postnatal variables...
September 2, 2017: Neonatology
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