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Chronic total occlusion

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https://www.readbyqxmd.com/read/28100874/efficacy-of-multidetector-computed-tomography-to-predict-periprocedural-myocardial-injury-after-percutaneous-coronary-intervention-for-chronic-total-occlusion
#1
Eisuke Usui, Tetsumin Lee, Tadashi Murai, Yoshihisa Kanaji, Junji Matsuda, Makoto Araki, Taishi Yonetsu, Yosuke Yamakami, Shigeki Kimura, Tsunekazu Kakuta
Specific signatures of culprit lesions detected on multidetector computed tomography (MDCT) were identified as predictors of periprocedural myocardial injury (PMI) after percutaneous coronary intervention (PCI) in patients with stable angina; PMI has been shown to be associated with a worse prognosis. We investigated the association between preprocedural culprit lesion characteristics, assessed by MDCT, and PMI after PCI for chronic total occlusion (CTO). From three medical centers, 81 patients who underwent pre-PCI MDCT and CTO PCI, and systematic cardiac troponin (cTn) sampling before and after PCI, were included...
January 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28096169/correction-to-procedural-and-long-term-outcomes-of-bioresorbable-scaffolds-versus-drug-eluting-stents-in-chronic-total-occlusions-the-bonito-registry-bioresorbable-scaffolds-versus-drug-eluting-stents-in-chronic-total-occlusions
#2
https://www.readbyqxmd.com/read/28091872/impact-of-revascularization-of-coronary-chronic-total-occlusion-on-left-ventricular-function-and-electrical-stability-analysis-by-speckle-tracking-echocardiography-and-signal-averaged-electrocardiogram
#3
Yohei Sotomi, Atsunori Okamura, Katsuomi Iwakura, Motoo Date, Hiroyuki Nagai, Tomohiro Yamasaki, Yasushi Koyama, Koichi Inoue, Yasushi Sakata, Kenshi Fujii
The present study aimed to assess the mechanisms of effects of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) from two different aspects: left ventricular (LV) systolic function assessed by two-dimensional speckle tracking echocardiography (2D-STE) and electrical stability evaluated by late potential on signal-averaged electrocardiogram (SAECG). We conducted a prospective observational study with consecutive CTO-PCI patients. 2D-STE and SAECG were performed before PCI, and after 1-day and 3-months of procedure...
January 13, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28089997/the-impact-of-age-and-sex-on-in-hospital-outcomes-of-chronic-total-occlusion-percutaneous-coronary-intervention
#4
Aris Karatasakis, Rahel Iwnetu, Barbara A Danek, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, David E Kandzari, Nicholas J Lembo, Mitul Patel, Ehtisham Mahmud, William L Lombardi, R Michael Wyman, J Aaron Grantham, Anthony H Doing, Catalin Toma, James W Choi, Barry F Uretsky, Jeffrey W Moses, Ajay J Kirtane, Ziad A Ali, Manish Parikh, Judit Karacsonyi, Bavana V Rangan, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: We sought to determine the effect of age and sex on procedural outcomes and efficiency of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We examined the clinical and angiographic characteristics and outcomes of 1675 CTO-PCIs performed in 1644 patients between 2012 and 2016 at 15 United States centers. RESULTS: Mean age was 65.3 ± 10 years and 1408 (86%) were men. Overall technical and procedural success rates were 88% and 87%, respectively...
January 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28089779/percutaneous-coronary-intervention-of-chronically-occluded-saphenous-vein-grafts-using-excimer-laser-atherectomy-as-an-adjuvant-therapy
#5
Mohsen Mohandes, Sergio Rojas, Mauricio Torres, Cristina Moreno, Francisco Fernández, Jordi Guarinos, Alfredo Bardají
We present two cases with chronic total occlusion of the saphenous vein graft in two patients with a history of previous bypass surgery with unfavorable anatomic features for recanalization of the native coronary artery. In the first case, two dedicated attempts for recanalization of chronic total occlusion of the native artery failed and in the second case there was not an adequate visualization of the native vessel beyond the occlusion point, not even by contralateral injection. Excimer laser atherectomy was used in both cases as an adjuvant therapy during recanalization of the saphenous vein graft in combination with a distal protection device in order to reduce distal embolization...
December 27, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28089148/percutaneous-revascularization-of-chronic-total-occlusions-rationale-indications-techniques-and-the-cardiac-surgeon-s-point-of-view
#6
Lorenzo Azzalini, Gianluca Torregrossa, John D Puskas, Emmanouil S Brilakis, William L Lombardi, Dimitri Karmpaliotis, Sunao Nakamura, Antonio Colombo, Mauro Carlino
Chronic total occlusions (CTO) are frequently found in clinical practice, yet they are still undertreated, despite the frequent presence of clinical indications for revascularization. The presence of a CTO is a frequent cause of incomplete revascularization, which has been associated with worse long-term outcomes (including mortality), compared to complete revascularization. Such low rates of attempted revascularization can be attributed to a common misconception about the lack of benefit of CTO revascularization, combined with historically lower success rates and higher complication rates of CTO percutaneous coronary intervention...
January 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28076619/oxidative-stress-in-human-aorta-of-patients-with-advanced-aortoiliac-occlusive-disease
#7
Márcio Luís Lucas, Cristina Campos Carraro, Adriane Belló-Klein, Antonio Nocchi Kalil, Newton Aerts
Introduction: Oxidative stress seems to be a role in the atherosclerosis process, but research in human beings is scarce. Objective: To evaluate the role of oxidative stress on human aortas of patients submitted to surgical treatment for advanced aortoiliac occlusive disease. Methods: Twenty-six patients were divided into three groups: control group (n=10) formed by cadaveric organ donors; severe aortoiliac stenosis group (patients with severe aortoiliac stenosis; n=9); and total aortoiliac occlusion group (patients with chronic total aortoiliac occlusion; n=7)...
November 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28069611/bioresorbable-vascular-scaffolds-for-the-treatment-of-chronic-total-occlusions-an-international-multicenter-registry
#8
Satoru Mitomo, Toru Naganuma, Yusuke Fujino, Hiroyoshi Kawamoto, Sandeep Basavarajaiah, Michael Pitt, Wei-Hsian Yin, Damras Tresukosol, Antonio Colombo, Sunao Nakamura
BACKGROUND: There are only limited studies reporting clinical outcomes after bioresorbable vascular scaffold (BVS; Absorb; Abbott Vascular, Santa Clara, CA) implantation for coronary chronic total occlusions (CTO). The aim of this study was to evaluate the real-world feasibility and safety of BVS implantation for the treatment of CTO. METHODS AND RESULTS: We retrospectively evaluated CTO cases treated with BVS from a multicenter registry. The primary end point was target lesion failure defined as a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization...
January 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28066662/-spiral-stenting-creating-a-subintimal-neo-luminal-helix-around-a-massively-calcified-ostial-chronic-total-occlusion-of-the-right-coronary-artery-in-a-patient-with-recurrent-ventricular-tachycardia
#9
Kambis Mashayekhi, Zivile Valuckiene, Hans Neuser, Marlon Walter, Wolfgang Gappmaier, Thomas Kaiser, Franz-Josef Neumann, Ibrahim Akin, Michael Behnes
This case report describes a successful percutaneous coronary intervention (PCI) of a severely calcified aorto-ostial chronic total occlusion (CTO) of the right coronary artery (RCA). The lesion was treated by a retrograde approach implementing long spiral subintimal wire tracking and final coronary stenting creating a subintimal neo-luminal helix around the natively occluded RCA. After 6 months of follow-up valuable angiographic results were proven.
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28062801/wire-escalation-in-emergent-revascularization-procedures-of-internal-carotid-artery-occlusions-the-use-of-high-tip-stiffness-microguidewires
#10
José E Cohen, Ronen R Leker, John M Gomori, Eyal Itshayek
OBJECTIVE: We examined the usefulness and safety of high tip stiffness cardiac microguidewires in the endovascular revascularization of selected cases of internal carotid artery (ICA) occlusion. METHODS: Files of patients with acute ischemic symptoms due to ICA occlusions managed from August 2010 to August 2016 by urgent endovascular revascularization were retrospectively reviewed with a waiver of informed consent. Cases where there was escalation to stiff tipped cardiovascular microguidewires after at least two failed attempts to cross the carotid occlusion with standard neuro-microguidewires were included...
January 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28057589/microsurgical-clipping-of-unruptured-intracranial-aneurysms-a-single-surgeon-s-experience-over-sixteen-years
#11
Anil Nanda, Devi Prasad Patra, Shyamal C Bir, Tanmoy K Maiti, Piyush Kalakoti, Papireddy Bollam
INTRODUCTION: Unruptured intracranial aneurysms (UIA) have become an issue of greater significance as their detection rates have increased over the years. We present the overall experience of microsurgical clipping of unruptured aneurysms by a single surgeon over a period of more than 16 years. METHODS: The clinical and radiological data were retrospectively reviewed. Clinical outcome at follow-up was assessed by Glasgow Outcome Scale (GOS), and angiograms were reviewed for the degree of occlusion...
January 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28050424/abdominal-angina-treated-by-urgent-percutaneous-angioplasty-an-excellent-alternative-to-surgical-revascularisation
#12
Vamsi Krishna Kamana, Ranjan Shetty, Anand M Krishnan, M Sudhakar Rao, Umesh Pai Malpe
Chronic Mesenteric Ischemia (CMI) presenting as acute abdomen can be treated percutaneously. An endovascular intervention has surpassed surgical revascularization over the past decade due to its lesser perioperative complication rate. Trans-femoral approach of revascularising is limited by its difficulty in coaxial alignment of the guiding catheter and hence, brachial artery and recently the radial approach have been utilized for mesenteric artery revascularisation for over a decade. Here by we report a case of chronic mesenteric ischemia having total occlusion of two and 70% occlusion of one of the three mesenteric vessels...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28045669/long-term-outcomes-of-successful-endovascular-therapy-via-the-retrograde-approach-for-below-the-knee-chronic-total-occlusion-in-patients-with-critical-limb-ischemia-after-a-failed-antegrade-approach
#13
Junya Matsumi, Takuma Takada, Noriaki Moriyama, Tomoki Ochiai, Kazuki Tobita, Koki Shishido, Kazuya Sugitatsu, Shingo Mizuno, Futoshi Yamanaka, Masato Murakami, Yutaka Tanaka, Saeko Takahashi, Takeshi Akasaka, Shigeru Saito
OBJECTIVE: This study evaluated long-term results following successful endovascular therapy (EVT) for chronic total occlusion (CTO) below the knee (BTK) using the retrograde approach after a failed antegrade approach. METHODS: Nineteen patients (19 limbs) with critical limb ischemia (CLI) who underwent successful EVT for BTK-CTO using the retrograde approach after a failed antegrade approach during 2010-2014 were studied. RESULTS: Mean duration of the follow-up period was 25...
January 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28045410/clinical-and-angiographic-outcomes-at-more-than-1-year-after-treatment-of-chronic-total-occlusions-with-the-everolimus-eluting-bioresorbable-vascular-scaffold
#14
Aylin Hatice Yamaç, Abdülkadir Yıldız, Meherrem Nasifov, Ahmet Taştan, Nemat Bashirov, Ömer Göktekin
OBJECTIVE: Treatment of chronic total occlusion (CTO) with everolimus-eluting bioresorbable vascular scaffold (BVS) is safe and effective at short-term follow-up (FU). The current study investigated clinical and angiographic outcomes after treatment of CTO with BVS at >1 year. METHODS: Thirty patients who underwent successful recanalization of 35 CTOs were included in this study. Quantitative coronary angiography (QCA) was performed at median FU period of 402 days...
December 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28044983/chronic-total-occlusion-in-non-infarct-related-artery-is-closely-associated-with-increased-five-year-mortality-in-patients-with-st-segment-elevation-acute-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-from-the-credo-kyoto-ami-registry
#15
Hiroki Watanabe, Takeshi Morimoto, Hiroki Shiomi, Yutaka Furukawa, Yoshihisa Nakagawa, Kenji Ando, Kazushige Kadota, Takeshi Kimura
AIMS: We sought to investigate the clinical impact of chronic total occlusion (CTO) in non-infarct-related artery (IRA) on long-term cardiovascular outcomes in patients with ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS: Among 5429 patients enrolled in the CREDO-Kyoto AMI registry, the current study population consisted of 2045 STEMI patients with multi-vessel disease (MVD) who underwent primary PCI within 24 hours after the symptom onset. The cumulative 5-year, 30-day and 30-day-to-5-year incidences of all-cause death were all significantly higher in the CTO group than in the non-CTO group (37...
January 3, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28044265/improvement-of-subjective-well-being-by-ranolazine-in-patients-with-chronic-angina-and-known-myocardial-ischemia-imwell-study
#16
Anthony A Bavry, Ki E Park, Calvin Y Choi, Ahmed N Mahmoud, Xuerong Wen, Islam Y Elgendy
INTRODUCTION: We aimed to assess if ranolazine would improve angina symptoms among patients with documented myocardial ischemia. METHODS: Eligible subjects had chronic stable angina and at least one coronary stenosis with fractional flow reserve (FFR) ≤0.80 or at least one chronic total occlusion (CTO) without attempted revascularization. Subjects were randomized to oral ranolazine 500 mg twice daily for 1 week, then ranolazine 1000 mg twice daily for 15 weeks versus matching placebo...
January 2, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28041711/bifurcation-lesions-involved-in-the-recanalization-process-of-coronary-chronic-total-occlusions-incidence-treatment-and-clinical-implications
#17
Soledad Ojeda, Manuel Pan, Alejandro Gutiérrez, Miguel Romero, Jorge Chavarría, Javier Suárez de Lezo, Francisco Mazuelos, Laura Pardo, Francisco Hidalgo, Francisco Carrasco, José Segura, Enrique Durán, Carlos Ferreiro, José J Sánchez, Sara Rodríguez, Jesús Oneto, Jose Suárez de Lezo
BACKGROUND: The presence of a bifurcation (BL) in the context of a coronary chronic total occlusion (CTO) represents an additional difficulty. This study analyzes the incidence of BLs in CTO recanalization, the treatment, predictors of bifurcation technical success and their clinical impact. METHODS AND RESULTS: BLs with a side branch (SB) ≥2.0mm located proximally, distally or within the occluded segment were observed in 130 (33%) of 391 CTO. Provisional stenting was the strategy more frequently used (94%)...
December 21, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28041697/validity-of-the-j-cto-score-and-the-cl-score-for-predicting-successful-cto-recanalization
#18
J E Guelker, L Bansemir, R Ott, T Rock, K Kroeger, R Guelker, H G Klues, D I Shin, A Bufe
BACKGROUND: Percutaneous coronary intervention (PCI) of total chronic coronary occlusion (CTO) still remains a major challenge in interventional cardiology. To predict the probability of a successful intervention different scoring systems are available. We analyzed in this study the validity of two scoring systems, the Japanese CTO score (J-CTO score) and the newly developed Clinical and Lesion-related score (CL Score). METHODS: Between 2012 and 2015 we included 379 consecutive patients...
December 27, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28040288/collateral-filling-efficiency-of-comorbid-chronic-total-occlusion-segment-on-short-term-mortality-in-st-elevation-myocardial-infarction
#19
Toshiharu Fujii, Masataka Nakano, Yohei Ohno, Gaku Nakazawa, Norihiko Shinozaki, Takashi Matsukage, Fuminobu Yoshimachi, Yuji Ikari
BACKGROUND: Collateral filling of chronic total occlusion (CTO) segments is considered to affect hemodynamic stability in primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) with CTO, however its value as a prognostic indicator for mortality is uncertain. The present study examined the relationship between collateral filling of CTO segments and short-term mortality in patients with STEMI with a comorbid CTO lesion. METHODS: Among 829 STEMI patients who underwent primary PCI, 74 patients with CTO were identified...
December 21, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28031659/successful-percutaneous-coronary-intervention-for-chronic-total-occlusion-of-left-anterior-descending-coronary-artery-in-a-patient-with-dextrocardia
#20
Ozlem Ozcan Celebi, Bulent Deveci, Erdogan Ilkay
Dextrocardia is a rare cardiac anomaly in which the heart is located in the right chest along with the cardiac long axis directing to the right and inferiorly. Although, it is a rare clinical phenomenon, coronary artery disease with dextrocardia is presumed to be of similar frequency as in the general population. Percutaneous coronary intervention has some technical difficulties in these patients. We hereby report a male patient with dextrocardia who was previously treated with coronary artery bypass graft surgery...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
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