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Chronic total occlusion

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https://www.readbyqxmd.com/read/29790720/recanalization-of-ctos-with-soundbitetm-active-wire
#1
Marianne Brodmann, Eric Thérasse, Andrew Benko, Louis-Philippe Riel, Steven Dion, Philippe Généreux, Martin Brouillette
BACKGROUND: The aim of this study was to examine the safety and efficacy of the SoundBite™ Crossing System for the recanalization of infrainguinal chronic total occlusion (CTO) lesions. CTOs are frequent among patients with severe claudication or critical limb ischemia. Failure to recanalize CTOs remains common and is associated with poor prognosis. The SoundBite™ Crossing System (SoundBite Medical Solutions Inc., Montreal, Canada) is a newly developed device that uses a 0.018-inch wire (SoundBite™ Active Wire) to deliver acoustic shock waves to the distal tip of a steerable guidewire to facilitate directed penetration of the proximal cap and crossing of the occlusion...
May 23, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29790719/less-is-more-as-less-as-reasonably-achievable-stenting-alaras-strategy-in-the-femoropopliteal-area
#2
Koen Deloose, Joren Callaert
BACKGROUND: Although evidence supports that the performance of drug coated balloons seems to be lesion complexity independent, it is quite clear that in long lesions, severe calcified lesions and chronic total occlusions, the bail out stent ratio is very high and that the "leaving nothing behind" strategy remains a dream in a lot of our daily cases. On the other side of the spectrum, "full metal jackets" of nitinol stents are creating even more problems. Stent fractures, intimal hyperplasia and reintervention difficulties complicate the recurrent vascular disease treatment...
May 23, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29790262/the-efficacy-and-tolerability-of-5-aminolevulinic-acid-5-thermosetting-gel-photodynamic-therapy-pdt-in-the-treatment-of-mild-to-moderate-acne-vulgaris-a-two-center-prospective-assessor-blinded-proof-of-concept-study
#3
Stefano Maria Serini, Maria Vittoria Cannizzaro, Annunziata Dattola, Virginia Garofalo, Esther Del Duca, Alessandra Ventura, Massimo Milani, Elena Campione, Luca Bianchi
BACKGROUND: Acne vulgaris is a chronic inflammatory skin disease, commonly treated with topical or systemic drugs, according to the severity of the condition. Retinoids and antibiotic compounds are considered cornerstone approaches in this condition. However, low adherence to the therapy and the issue of bacterial resistance undermine the efficacy in the long term. Photodynamic therapy (PDT) with 20% aminolevulinic acid (ALA) has shown to be effective in the treatment of inflammatory acne...
May 22, 2018: Journal of Cosmetic Dermatology
https://www.readbyqxmd.com/read/29789906/percutaneous-intentional-intra-luminal-assisted-recanalization-pilar-technique-of-challenging-chronic-total-occlusions-using-a-high-frequency-vibration-device
#4
Stephanie Volpi, Amine Chouiter, Francois Saucy, Steven Hajdu, Anne-Marie Jouannic, Salah D Qanadli
OBJECTIVES: Recanalization of peripheral chronic total occlusions (CTO) is technically challenging especially in cases of in-stent and/or pre-stent and heavily calcified lesions. A high-frequency vibrational device (HFVD) was first used as a secondary-intention device in CTO recanalizations when they were refractory to a guidewire. The aim of this study was to assess the safety and efficacy of the HFVD as a first-line treatment for challenging CTOs and thus to define the percutaneous intentional intraluminal-assisted recanalization (PILAR) technique...
May 22, 2018: European Radiology
https://www.readbyqxmd.com/read/29789335/prediction-of-thrombotic-and-bleeding-events-after-percutaneous-coronary-intervention-credo-kyoto-thrombotic-and-bleeding-risk-scores
#5
Masahiro Natsuaki, Takeshi Morimoto, Kyohei Yamaji, Hirotoshi Watanabe, Yusuke Yoshikawa, Hiroki Shiomi, Yoshihisa Nakagawa, Yutaka Furukawa, Kazushige Kadota, Kenji Ando, Takashi Akasaka, Keiichi Igarashi Hanaoka, Ken Kozuma, Kengo Tanabe, Yoshihiro Morino, Toshiya Muramatsu, Takeshi Kimura
BACKGROUND: Prediction of thrombotic and bleeding risk is important to optimize antithrombotic therapy after percutaneous coronary intervention. METHODS AND RESULTS: We developed the prediction rules for thrombotic and bleeding events separately in Japanese patients. Derivation and validation cohorts consisted of 4778 patients from CREDO-Kyoto (Coronary Revascularization Demonstrating Outcome Study in Kyoto) registry cohort 2 and 4669 patients from RESET (Randomized Evaluation of Sirolimus-Eluting Versus Everolimus-Eluting Stent Trial) and NEXT (Nobori Biolimus-Eluting Versus Xience/Promus Everolimus-Eluting Stent Trial)...
May 22, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29780037/past-and-present-work-practices-of-european-interventional-cardiologists-in-the-context-of-radiation-protection-of-the-eye-lens-results-of-the-euraloc-study
#6
Joanna Karolina Domienik-Andrzejewska, Olivera Ciraj-Bjelac, Panagiotis Askounis, Peter Covens, Octavian Dragusin, Sophie Jacob, Jad Farah, Emilio Gianicolo, Renato Padovani, Pedro Manuel Peixoto Teles, Anders Widmark, Lara Struelens
This paper investigates over five decades of work practices in interventional cardiology with special emphasis on radiation protection. The analysis is based on the data from more than 400 cardiologists from different European countries recruited for EURALOC study collected in the period from 2014 to 2016. Information on the types of procedures performed and their annual mean number, fluoroscopy time, access site choice, X-ray units and radiation protection means used was collected using an occupational questionnaire...
May 21, 2018: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
https://www.readbyqxmd.com/read/29769055/one-visceral-artery-may-be-enough-successful-pancreatectomy-in-a-patient-with-total-occlusion-of-the-celiac-and-superior-mesenteric-arteries
#7
Evangelos Tagkalos, Florian Jungmann, Hauke Lang, Stefan Heinrich
BACKGROUND: The anatomic variations of the visceral arteries are not uncommon. The liver arterial blood supply shows 50% variability between humans, with the most common anatomy being one hepatic artery arising from the celiac trunk and one pancreatico-duodenal arcade between the celiac trunk and the superior mesenteric artery. Occlusion of one artery are mostly asymptomatic but may become clinically relevant when surgery of the liver, bile duct or the pancreas is required. If these pathologies are not reversible, an oncologic pancreatic head resection cannot be performed...
May 16, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29766928/parent-artery-sacrifice-for-ruptured-aneurysms-in-acute-and-chronic-phases-a-systematic-review
#8
REVIEW
Xianli Lv, Wei Li, Huijian Ge, Hengwei Jin, Hongwei He, Chuhan Jiang, Youxiang Li
Background: Experience with respect to parent vessel sacrifice (PVS) for unclippable/uncoilable ruptured aneurysms is limited. Objective: The aim of the present systematic review was to evaluate the risk of PVS for unclippable/uncoilable ruptured aneurysms. Materials and Methods: The PUBMED and SCIENCEDIRECT databases were searched using "parent vessel occlusion OR parent artery occlusion" AND "acute subarachnoid hemorrhage" till December 27, 2015, and 1 journal was searched from November 1995 to April 2016 for relevant results...
May 2018: Neurology India
https://www.readbyqxmd.com/read/29764036/-comparison-of-prognostic-value-of-18-f-fdg-pet-ct-myocardial-metabolism-imaging-and-coronary-collateral-circulation-in-patients-with-cto-lesions
#9
G Y Zhai, J L Wang, Y Y Liu, Y J Zhou
Objective: To evaluate the location, extent of viable myocardial of chronic total coronary occlusions(CTO)lesions by (18)F-FDG PET myocardial metabolism imaging and then compare with coronary collateral circulation(CCC) to evaluate the prognostic evaluation in patients with CTO lesions. Methods: A total of Sixty consecutive patients with CTO lesions referred for viability assessment from April 2016 to April 2017 in Department of Cardiology, Beijing Anzhen Hospital were included in the study. These patients underwent (99m)Tc-sestamibi ECG-gated SPECT rest myocardial perfusion imaging and ECG-gated (18)F-FDG PET/CT myocardial metabolic imaging, as well as coronary arteriography were recruited in this study...
May 8, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29762235/quality-and-safety-in-health-care-part-xl-stents-and-unusual-indications-for-a-pci
#10
Jay A Harolds
Percutaneous coronary interventions (PCI) are done for a variety of indications. Data from the CathPCI Registry is highly useful to evaluate the outcomes from performing a PCI procedure in unusual circumstances, such as in cases of chronic total coronary artery occlusion, cardiogenic shock after a myocardial infarction, syncopal patients, asymptomatic patients, and before surgery that is noncardiac. Registry information is also valuable in evaluating the efficacy of coronary stents. This article summarizes some of the information available on these subjects...
May 14, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29761968/-computer-assisted-quantitative-analysis-of-contrast-enhanced-ultrasonography-in-takayasu-arteritis-carotid-artery-lesions
#11
Yanlu Hu, Qi Zhang, Chaolun Li
Takayasu arteritis (TA) is a chronic nonspecific inflammation that commonly occurs in the aorta and its main branches. Most patients with TA are lack of clinical manifestations, leading to misdiagnosis. When the TA is correctly diagnosed, the patients may already have stenosis or occlusion in the involved arteries, resulting in arterial ischemia and hypoxia symptoms, and in severe cases it will be life-threatening. Contrast-enhanced ultrasonography (CEUS) is an emerging method for assessing TA, but the assessment relies heavily on experiences of radiologists performing manual and qualitative analyses, so the diagnostic results are often not accurate...
October 1, 2017: Sheng Wu Yi Xue Gong Cheng Xue za Zhi, Journal of Biomedical Engineering, Shengwu Yixue Gongchengxue Zazhi
https://www.readbyqxmd.com/read/29754928/pathological-mechanisms-of-left-main-stent-failure
#12
Hiroyoshi Mori, Sho Torii, Emanuel Harari, Hiroyuki Jinnouchi, Ryan Brauman, Samantha Smith, Robert Kutys, David Fowler, Maria Romero, Renu Virmani, Aloke V Finn
BACKGROUND: Despite the increasing use of left main (LM) percutaneous coronary intervention (LM-PCI), there have been no pathological studies devoted to understanding the causes of LM stent failure. We aimed to systematically determine the pathological mechanisms of LM stent failure. METHODS AND RESULTS: From the CVPath Stent registry, a total of 46 lesions were identified to have LM-PCI. Pathologic stent failure (PSF) was defined as stent thrombosis, restenosis and in-stent chronic total occlusion (CTO)...
July 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29754161/motion-corrected-whole-heart-pet-mr-for-the-simultaneous-visualisation-of-coronary-artery-integrity-and-myocardial-viability-an-initial-clinical-validation
#13
Camila Munoz, Karl P Kunze, Radhouene Neji, Teresa Vitadello, Christoph Rischpler, René M Botnar, Stephan G Nekolla, Claudia Prieto
PURPOSE: Cardiac PET-MR has shown potential for the comprehensive assessment of coronary heart disease. However, image degradation due to physiological motion remains a challenge that could hinder the adoption of this technology in clinical practice. The purpose of this study was to validate a recently proposed respiratory motion-corrected PET-MR framework for the simultaneous visualisation of myocardial viability (18 F-FDG PET) and coronary artery anatomy (coronary MR angiography, CMRA) in patients with chronic total occlusion (CTO)...
May 12, 2018: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29747322/-safety-and-efficacy-of-rotational-atherectomy-in-the-interventional-treatment-of-coronary-chronic-total-occlusion-lesions
#14
J Y Ma, J J Guo, L Hou, F Zhang, K Yao, D Huang, H Lu, Y X Dai, C G Li, S F Chang, Q Qin, L Ge, J Y Qian, J B Ge
Objective: To investigate the safety and efficacy of rotational atherectomy in the interventional treatment of coronary chronic total occlusion lesions. Methods: In this retrospective study,a total of 31 consecutive patients with coronary chronic total occlusion(CTO) lesions underwent rotational atherectomy in our hospital from February 2004 to December 2016 were enrolled,and the clinical features were analyzed. Coronary atherectomy was performed if balloon failed to cross the CTO lesions or balloon could not be fully dilated in the CTO lesions after wire crossing...
April 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29743412/successful-retrieval-of-entrapped-gaia-guidewire-in-calcified-chronic-total-occlusion-using-rotational-atherectomy-device
#15
Jae Young Cho, Soon Jun Hong
We report a novel technique for retrieving an entrapped Gaia guidewires in severely calcified coronary chronic total occlusion (CTO) using a rotational atherectomy device. By successfully cutting the entrapped and untangled guidewire within the CTO with the use of a rotational atherectomy device, we could effectively remove the Gaia guidewire from the right coronary artery.
May 9, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29741489/initial-result-of-angioscopy-guided-wire-crossing-technique-under-continuous-saline-infusion-for-chronic-total-occlusion-in-femoropopliteal-disease
#16
Masamichi Yano, Keisuke Yasumura, Koji Yasumoto, Akihiro Tanaka, Naoki Mori, Daisuke Nakamura, Yasuyuki Egami, Ryu Shutta, Jun Tanouchi, Masami Nishino
AIMS: We occasionally experience endovascular therapy (EVT) failure as a consequence of wire-crossing into the subintima for chronic total occlusion (CTO) in peripheral arteries. Although several reports have demonstrated the importance of accurate wire-crossing into the ostial site of the CTO true lumen to succeed, it is difficult to visualize the CTO ostium before wiring using angiography or intravascular ultrasonography (IVUS). Thus, we directly visualize the ostial sites of lesions and wire manipulation during EVT by angioscopy and evaluate the efficacy and safety of angioscopy-guided EVT under continuous infusion of saline (AGECIS) in peripheral arteries...
May 8, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29726047/intravascular-ultrasound-guided-wiring-re-entry-technique-for-complex-chronic-total-occlusions
#17
Wei-Chieh Huang, Hsin-I Teng, Chien-Hung Hsueh, Shing-Jong Lin, Wan-Leong Chan, Tse-Min Lu
BACKGROUND: The successful recanalization rate of chronic total occlusion (CTO) lesions without retrograde collaterals available is always low. Intravascular ultrasound (IVUS) may be useful to guide the subintimal guidewire to re-enter the true lumen. We evaluated the clinical feasibility and efficacy of the IVUS-guided wiring re-entry technique for these complex CTO lesions. METHODS: Twenty consecutive patients (19 male, mean age: 65.3 ± 12.8 years) with both failed antegrade and retrograde approaches were enrolled...
May 3, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29724977/first-successful-percutaneous-treatment-of-a-totally-occluded-heartware-outflow-graft-case-report-and-literature-review
#18
Cemal Kemaloğlu, Refik Emre Altekin, Ömer Bayezid
As the number of implanted left ventricular assist devices (LVADs) used increases, the frequency of chronic complications encountered also increases. The pause of blood flow in the outflow graft is a rare, but fatal, complication. The aim of this article was to present the case of a patient in whom HeartWare outflow graft occlusion was removed by balloon angioplasty and to examine the treatment modalities of HeartWare outflow graft occlusions that have been percutaneously performed to date. The literature was searched for percutaneous interventions on outflow grafts of the left ventricular assist devices...
May 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29724974/comparison-of-the-transradial-and-transfemoral-approach-in-treatment-of-chronic-total-occlusions-with-similar-lesion-characteristics
#19
Mustafa Ahmet Huyut, Aylin Hatice Yamaç
OBJECTIVE: There is limited data on the efficacy and the safety of the transradial approach (TRA) for percutaneous coronary intervention (PCI) of chronic total occlusion (CTO), particularly in comparison with the transfemoral approach (TFA) in lesions with similar complexity. METHODS: We included 358 patients, who underwent elective CTO PCI between January 2012 and August 2017 and compared the radial (179 patients) and femoral (179 patients) approaches. The J-CTO score was similar in both groups (TRA, 2...
May 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29722796/a-randomized-multicentre-trial-to-compare-revascularization-with-optimal-medical-therapy-for-the-treatment-of-chronic-total-coronary-occlusions
#20
Gerald S Werner, Victoria Martin-Yuste, David Hildick-Smith, Nicolas Boudou, Georgios Sianos, Valery Gelev, Jose Ramon Rumoroso, Andrejs Erglis, Evald Høj Christiansen, Javier Escaned, Carlo di Mario, Thomas Hovasse, Luis Teruel, Alexander Bufe, Bernward Lauer, Kris Bogaerts, Javier Goicolea, James C Spratt, Anthony H Gershlick, Alfredo R Galassi, Yves Louvard
Aims: The clinical value of percutaneous coronary intervention (PCI) for chronic coronary total occlusions (CTOs) is not established by randomized trials. This study should compare the benefit of PCI vs. optimal medical therapy (OMT) on the health status in patients with at least one CTO. Method and results: Three hundred and ninety-six patients were enrolled in a prospective randomized, multicentre, open-label, and controlled clinical trial to compare the treatment by PCI with OMT with a 2:1 randomization ratio...
May 2, 2018: European Heart Journal
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