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Chronic total occlusion

Lorenzo Azzalini, Gennaro Giustino, Soledad Ojeda, Antonio Serra, Alessio La Manna, Hung Q Ly, Barbara Bellini, Susanna Benincasa, Jorge Chavarría, Livia L Gheorghe, Giovanni Longo, Eligio Miccichè, Guido D'Agosta, Fabien Picard, Manuel Pan, Corrado Tamburino, Azeem Latib, Mauro Carlino, Alaide Chieffo, Antonio Colombo
BACKGROUND: There is little evidence regarding the efficacy and safety of bioresorbable scaffolds (BRS) for the percutaneous treatment of chronic total occlusions. METHODS AND RESULTS: We performed a multicenter registry of consecutive chronic total occlusion patients treated with BRS (Absorb; Abbott Vascular) and second-generation drug-eluting stents (DES) at 5 institutions. Long-term target-vessel failure (a composite of cardiac death, target-vessel myocardial infarction, and ischemia-driven target-lesion revascularization) was the primary end point...
October 2016: Circulation. Cardiovascular Interventions
Roberto Gandini, Costantino Del Giudice
OBJECTIVES: The aim of this study was to evaluate the safety and efficacy of percutaneous catheter-delivered ultrasound energy to improve local paclitaxel delivery effects in patients with critical limb ischemia (CLI) treated for femoral-popliteal arterial disease. BACKGROUND: Treatment of patients with CLI continues to be the greatest challenge in peripheral artery disease; in particular, treatment of femoral-popliteal chronic total occlusion is characterized by poor primary patency...
October 24, 2016: JACC. Cardiovascular Interventions
Ying Shen, Feng Hua Ding, Rui Yan Zhang, Qi Zhang, Lin Lu, Wei Feng Shen
The data presented here support the research article "Association of serum mimecan with angiographic coronary collateralization in patients with stable coronary artery disease and chronic total occlusion" (Shen et al., 2016) [1] where elevated circulating mimecan levels reflected poor angiographic coronary collateralization in such patients. The data included in this article are composed by one figure and consist of (1) validation of serum mimecan measurement by assessing inter- and intra-assay variability in 45 samples; (2) findings on the relation of clinical and angiographic characteristics and biochemical parameters to coronary collateralization in 559 patients; (3) the diagnostic value of serum mimecan for poor collateralization, which was derived from plotting receiver-operating characteristic curves and logistic regression analysis...
December 2016: Data in Brief
Vladimir Dedovic, Goran Stankovic
Despite permanent improvement in success rate and technical developments, chronic total occlusion (CTO) remains undertreated by percutaneous coronary intervention (PCI). Dedicated CTO operators from Japan, Europe and USA perform these procedures with success rate beyond 90%, but there is still huge gap between this group of specialists and broader population of PCI operators. Recently proposed CTO scores can be used for patients' selection according to the CTO operators' experience. Patients with low CTO score values may be suitable for less experienced operators at the beginning of the CTO PCI learning curve, while more complex CTOs (higher CTO score values) should be differed to CTO experts...
October 19, 2016: Panminerva Medica
James Sapontis, Steven P Marso, David J Cohen, William Lombardi, Dimitri Karmpaliotis, Jeffrey Moses, William J Nicholson, Ashish Pershad, R Michael Wyman, Anthony Spaedy, Stephen Cook, Parag Doshi, Robert Federici, Craig R Thompson, Karen Nugent, Kensey Gosch, John A Spertus, J Aaron Grantham
BACKGROUND: Patients with chronic total occlusions of a coronary artery represent a complex, yet common, clinical conundrum among patients with ischemic heart disease. Chronic total occlusion angioplasty is increasingly being used as a treatment for these complex lesions. There is a compelling need to better quantify the safety, efficacy, benefits, and costs of the procedure. METHODS: To address these gaps in knowledge, we designed the Outcomes, Patient Health Status, and Efficiency IN Chronic Total Occlusion Hybrid Procedures (OPEN CTO) study, an investigator-initiated multicenter, single-arm registry including 12 centers with a planned enrollment of 1000 patients...
October 13, 2016: Coronary Artery Disease
Mohit D Gupta, M P Girish, Sudhansu Sekhar Parida, Sanjay Tyagi
Intercoronary communications (ICC) or open-ended coronary circulation is rare. We describe intercoronary communication in a case of chronic total occlusion, and discuss the pathophysiological and clinical significance of these rare entities. The present case also demonstrates the anatomical presence of ICC despite angiographic absence for the first time using CT coronary angiography.
September 2016: Indian Heart Journal
Sheshagiri Rao Damera, Ramachandra Barik, Akula Siva Prasad
The angioplasty of chronic total aortoiliac occlusion using transfemoral is controversial. From March 2014 to December 2015, four consecutive patients (4 males; mean age 58.2±6.8 years; age of range 51-65 years) underwent angioplasty and stenting of TASC-D occlusion. In all the cases, we failed to cross from femoral approach. On switching over to left brachial access, angioplasty was done successfully in all. There was no procedural site complication or clinical evidence cerebral thromboembolism. Self-expandable stents were implanted in all with adequate pre and post dilation...
September 2016: Indian Heart Journal
Mohamad Lazkani, Divya Ratan Verma, Michael Morris, Ashish Pershad
Preprocedural planning and advanced imaging is vital to achieve a consistent and high level of success for complex coronary chronic total occlusion (CTO) revascularization. Various practice patterns exist around the world when performing coronary artery CTO revascularization. This case report highlights a fusion of global practices in CTO intervention and integration of advanced imaging to achieve successful revascularization.
September 2016: Indian Heart Journal
Lei Zhao, Long-Bo Li, Zhi-Hui Wang, Yong-Feng Shi, Jun-Duo Wu, Ji-Chang Zhang, Bin Liu
BACKGROUND: The CrossBoss coronary chronic total occlusion (CTO) crossing catheter has been demonstrated to have greatly improved the success rate of crossing CTO lesions, but there are no published data on its application for in-stent CTO lesions. METHODS: In the current study, we retrospectively reviewed the clinical data of 8 patients with in-stent CTO lesions that were managed with the CrossBoss catheter and herein we report the efficacy and safety of the CrossBoss crossing and re-entry system for this clinically challenging condition...
October 2016: Medicine (Baltimore)
Bimmer E Claessen, Loes P Hoebers, Joelle E Elias, Ivo M van Dongen, José P S Henriques
No abstract text is available yet for this article.
September 2016: Journal of Thoracic Disease
Aris Karatasakis, Barbara Anna Danek, Emmanouil S Brilakis
No abstract text is available yet for this article.
September 2016: Journal of Thoracic Disease
Dong-Ho Shin, Sung-Jin Hong, Gary S Mintz, Jung-Sun Kim, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong-Ki Hong
OBJECTIVES: The aim of this study was to evaluate the clinical usefulness of intravascular ultrasound (IVUS)-guided new-generation drug-eluting stent (DES) implantation using a meta-analysis of individual patient-level data from randomized trials. BACKGROUND: Published randomized trials that compare IVUS-guided versus angiography-guided new-generation DES implantation are scarce. METHODS: Searches of the MEDLINE, Embase, and Cochrane databases were performed to find randomized trials that compared IVUS-guided versus angiography-guided new-generation DES implantation...
October 6, 2016: JACC. Cardiovascular Interventions
James Torey, Anwar Zaitoun, Thomas Lalonde, John Runyon, Jihad Mustapha, Thomas Davis
OBJECTIVES: CENTRAL was a prospective, multicenter, 100 patient study designed to evaluate the ability of a recanalization catheter system to cross chronic total occlusions (CTOs) of the superficial femoral artery while staying within the central vessel lumen. METHODS: The primary endpoint was the successful crossing of a CTO (≥90% of the length) with the recanalization catheter in the central lumen of the superficial femoral artery in at least one-half of the studied patient population, confirmed by intravascular ultrasound...
October 15, 2016: Journal of Invasive Cardiology
Wonho Kim, Ramon Quesada, Melanie B Schernthaner, Raul E Herrera, Juan-Carlos Zevallos, Victor N Becerra, Juan M Acuña, Barry T Katzen
OBJECTIVE: We investigated whether successful revascularization of total occlusion of a large lower-extremity artery is associated with improvement of left ventricular (LV) diastolic function. BACKGROUND: Total occlusion of a large lower-extremity artery might affect the systemic vascular resistance and increase the afterload, because the left ventricle must work harder to eject blood into a smaller vascular bed. Chronic elevation of afterload is a cause of LV diastolic dysfunction...
October 15, 2016: Journal of Invasive Cardiology
J R Martinez-Parachini, A Karatasakis, D Karmpaliotis, K Alaswad, F A Jaffer, R W Yeh, M Patel, J Bahadorani, A Doing, P-K Nguyen-Trong, B A Danek, J Karacsonyi, A Alame, B V Rangan, C A Thompson, Subhash Banerjee, E S Brilakis
AIM: To examine the impact of diabetes mellitus on procedural outcomes of patients who underwent percutaneous coronary intervention for chronic total occlusion. METHODS: We assessed the impact of diabetes mellitus on the outcomes of percutaneous coronary intervention for chronic total occlusion among 1308 people who underwent such procedures at 11 US centres between 2012 and 2015. RESULTS: The participants' mean ± sd age was 66±10 years, 84% of the participants were men and 44...
October 15, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
Philine J Köln, Bruno Scheller, Houng Bang Liew, Tuomas T Rissanen, Wan Azman Wan Ahmad, Ralf Weser, Telse Hauschild, Amin Ariff Nuruddin, Yvonne P Clever, Hee Hwa Ho, Franz X Kleber
BACKGROUND: Chronic total occlusions remain one of the biggest challenges for interventional cardiologists and the high risk of restenosis and stent thrombosis is still a major problem. Drug-coated balloons showed favorable results for the treatment of in-stent restenosis and other lesion types. The aim of this study was to evaluate the feasibility and outcome of a drug-coated balloon only approach for chronic total occlusion. METHODS: We included 34 patients with a native chronic total occlusion treated only by drug-coated balloons...
September 27, 2016: International Journal of Cardiology
Hsiu-Yu Fang, Wei-Chieh Lee, Chih-Yuan Fang, Chiung-Jen Wu
Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) has recently become popular among interventional cardiologists. CTO originating from the ostium has been one of the most difficult CTO lesions to treat with PCI for a number of reasons. Our aim was to illustrate a specific technique during retrograde CTO PCI referred to as the "snare technique."We retrospectively examined the use of "snare technique" among 371 consecutive retrograde CTO PCIs performed at our institution between 2006 and 2015...
October 2016: Medicine (Baltimore)
Tatsuya Nishikawa, Masashi Fujino, Ikutaro Nakajima, Yasuhide Asaumi, Yu Kataoka, Toshihisa Anzai, Kengo Kusano, Teruo Noguchi, Yoichi Goto, Kunihiro Nishimura, Yoshihiro Miyamoto, Keisuke Kiso, Satoshi Yasuda
AIMS: The prognostic impact of chronic total coronary occlusion (CTO) on implantable cardioverter-defibrillator (ICD) recipients remains unclear. METHODS AND RESULTS: Eighty-four consecutive patients with ischaemic heart disease who received ICD therapy for primary or secondary prevention were analysed. We investigated all-cause mortality and major adverse cardiac events (MACEs) including cardiac death, appropriate device therapy, hospitalization for heart failure, and ventricular assist device implantation...
October 13, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Young Ho Jung, Seong Joon Ahn, Jeong-Ho Hong, Kyu Hyung Park, Moon-Ku Han, Cheolkyu Jung, Se Joon Woo
PURPOSE: To investigate the incidence of neovascularization of the iris (NVI) and clinical features of patients with NVI following acute central retinal artery occlusion (CRAO). METHODS: A retrospective review of 214 consecutive CRAO patients who visited one tertiary hospital between January 2009 and January 2015 was conducted. In total, 110 patients were eligible for this study after excluding patients with arteritic CRAO, a lack of follow-up, iatrogenic CRAO secondary to cosmetic filler injection, or NVI detected before CRAO attack...
October 2016: Korean Journal of Ophthalmology: KJO
Takashi Kawakami, Aiko Ogawa, Katsumasa Miyaji, Hiroki Mizoguchi, Hiroto Shimokawahara, Takanori Naito, Takashi Oka, Kei Yunoki, Mitsuru Munemasa, Hiromi Matsubara
BACKGROUND: Balloon pulmonary angioplasty (BPA) is an alternative therapy for patients with chronic thromboembolic pulmonary hypertension who are ineligible for standard therapy, pulmonary endarterectomy. Although there are several classifications of vascular lesions, these classifications are based on the features of the specimen removed during pulmonary endarterectomy. Because organized thrombi are not removed during balloon pulmonary angioplasty, we attempted to establish a new classification of vascular lesions based on pulmonary angiographic images...
October 2016: Circulation. Cardiovascular Interventions
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