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Coronary chronic occlusion

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https://www.readbyqxmd.com/read/28342253/ipsilateral-vs-contralateral-vs-no-collateral-antegrade-only-chronic-total-occlusion-percutaneous-coronary-interventions-what-is-the-right-choice-for-your-practice
#1
EDITORIAL
Lorenzo Azzalini, Emmanouil S Brilakis
No abstract text is available yet for this article.
March 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28341287/outcomes-of-the-retrograde-approach-through-epicardial-versus-non-epicardial-collaterals-in-chronic-total-occlusion-percutaneous-coronary-intervention
#2
Susanna Benincasa, Lorenzo Azzalini, Mauro Carlino, Barbara Bellini, Francesco Giannini, Xiaohui Zhao, Antonio Colombo
BACKGROUND: The retrograde approach through epicardial collaterals (EC) for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is a challenging procedure. Our study aim was to evaluate the outcomes of patients undergoing CTO PCI using a retrograde approach through epicardial versus non-epicardial collaterals (NEC). METHODS: We collected data from our single-center registry of consecutive patients undergoing retrograde CTO PCI, performed by an experienced operator through EC and NEC (septals and bypass grafts)...
March 14, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28338117/endovascular-treatment-for-acute-mesenteric-ischaemia-in-a-young-woman-with-polyarterial-disease
#3
Mihai C Ober, Calin Homorodean, Dan A Tataru, Antonia E Macarie, Camelia D Ober, Dan M Olinic
BACKGROUND: Acute mesenteric ischaemia is a condition with a grim prognosis on conservative treatment. Endovascular revascularisation is a promising approach for some of these patients. CASE REPORT: We present the case of a 44-year-old woman with a history of severe arterial hypertension, left leg claudication, and overlooked symptoms of chronic mesenteric ischaemia for one year, who was admitted for severe abdominal pain for one week. Computed tomographic angiography (CTA) showed acute mesenteric ischaemia by occlusion of the coeliac trunk and the superior mesenteric artery (SMA), without bowel perforation...
March 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28335896/collateral-damage-sufficient-coronary-collaterals-provide-important-yet-limited-protection-in-chronic-total-occlusions
#4
EDITORIAL
Rushi V Parikh, William F Fearon
No abstract text is available yet for this article.
March 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28335895/coronary-collaterals-function-and-clinical-outcome-between-patients-with-acute-and-chronic-total-occlusion
#5
Jang Hoon Lee, Chang-Yeon Kim, Namkyun Kim, Se Yong Jang, Myung Hwan Bae, Dong Heon Yang, Yongkeun Cho, Shung Chull Chae, Hun Sik Park
OBJECTIVES: This study sought to demonstrate how changes in the collateral function and its clinical significance before and after percutaneous coronary interventions (PCIs) are compared between patients with acute coronary syndrome and total or nearly total occlusions (ATOs) and chronic total occlusions (CTOs). BACKGROUND: The functional relevance of the collateral circulation in patients with ATOs and CTOs has not been fully investigated. METHODS: The pressure-derived collateral pressure index (CPI), myocardial fractional flow reserve (FFRmyo), and coronary fractional flow reserve (FFRcor) at maximum hyperemia induced by intravenous adenosine were evaluated in occluded vessels at baseline, after the PCI, and at 1 year in 23 ATO and 74 CTO patients...
March 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28330969/influence-of-the-coronary-circulation-on-thermal-tolerance-and-cardiac-performance-during-warming-in-rainbow-trout
#6
Andreas Ekström, Michael Axelsson, Albin Gräns, Jeroen Brijs, Erik Sandblom
Thermal tolerance in fish may be related to an oxygen limitation of cardiac function. While the hearts of some fish species receive oxygenated blood via a coronary circulation, the influence of this oxygen supply on thermal tolerance and cardiac performance during warming remain unexplored. Here, we analyzed the effect in vivo of acute warming on coronary blood flow in adult sexually mature rainbow trout (Onchorhynchus mykiss), and the consequences of chronic coronary ligation on cardiac function and thermal tolerance in juvenile trout...
February 22, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28325520/percutaneous-revascularization-of-coronary-chronic-total-occlusion-toward-a-reappraisal-of-the-available-evidence
#7
REVIEW
Pasi P Karjalainen, Wail Nammas
Chronic total occlusion (CTO) is a challenging subset of coronary artery disease that is commonly encountered in real-world practice; it is associated with worse long-term prognosis. Observational studies suggest that percutaneous coronary intervention (PCI) for CTO is associated with reduction in myocardial ischemia and improvement in quality of life and left ventricular function. Some observational studies suggested that CTO-PCI is associated with improvement of the 'hard' clinical endpoints; others did not...
March 18, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28318134/long-term-clinical-outcomes-of-successful-revascularization-with-drug-eluting-stents-for-chronic-total-occlusions-a-systematic-review-and-meta-analysis
#8
REVIEW
Lei Gao, Yabin Wang, Yuqi Liu, Feng Cao, Yundai Chen
OBJECTIVES: To determine whether successful percutaneous coronary intervention (PCI) using drug-eluting stents (DESs) have beneficial effects on long-term outcomes in patients with chronic total occlusions (CTOs) compared with failed PCIs for CTOs. BACKGROUND: Several observational studies have evaluated the long-term clinical outcomes of successful PCIs using DESs for CTOs. However, the results of these studies were inconsistent and inconclusive. METHODS: We searched five online electronic databases to identify all the publications assessing the long-term outcomes of successful and failed PCIs using DESs for CTOs...
March 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28316035/management-of-percutaneous-coronary-intervention-complications
#9
REVIEW
Gregory Means, Christopher End, Prashant Kaul
With the recent increase in complex coronary interventions including percutaneous coronary intervention (PCI) for chronic total occlusions and complex higher risk (and indicated) patients, the spectrum of potential periprocedural complications and their prompt management has become even more relevant. Vascular access-related problems remain the most prevalent of all PCI complications and with randomized controlled trial data from over 20,000 patients supporting the superiority of radial over femoral access in reducing bleeding and vascular complications, a default radial strategy should be promoted...
April 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28315181/update-on-the-management-of-chronic-total-occlusions-in-coronary-artery-disease
#10
REVIEW
Kathleen Kearney, Ravi S Hira, Robert F Riley, Arun Kalyanasundaram, William L Lombardi
PURPOSE OF THE REVIEW: Chronic total occlusions (CTOs) are found in about a third of patients with coronary artery disease (CAD) and can pose a significant challenge during percutaneous revascularization. However, advances in CTO percutaneous coronary intervention (PCI) strategies, devices, and algorithms have led to significant improvements in successful treatment of CTOs. This review summarizes current management of CTOs in the context of modern PCI techniques and current evidence. RECENT FINDINGS: The hybrid algorithm now provides a standardized, teachable approach to CTO PCI, and success rates are approximately 90% in experienced hands...
April 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28314674/further-validation-of-the-hybrid-algorithm-for-cto-pci-difficult-lesions-same-success
#11
Mir B Basir, Aris Karatasakis, Mohammad Alqarqaz, Barbara Danek, Bavana V Rangan, Emmanouil S Brilakis, Henry Kim, William W O'Neill, Khaldoon Alaswad
OBJECTIVES: To evaluate the success rates and outcome of the hybrid algorithm for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) by a single operator in two different clinical settings. METHODS: We compared 279 consecutive CTO PCIs performed by a single, high-volume operator using the hybrid algorithm in two different clinical settings. Data were collected through the PROGRESS CTO Registry. We compared 145 interventions performed in a community program (cohort A) with 134 interventions performed in a referral center (cohort B)...
February 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28314672/fenestration-of-a-papyrus-pk-covered-stent-to-recover-the-occluded-left-main-bifurcation-after-sealing-a-left-main-perforation-during-a-cto-procedure
#12
Gerald S Werner, Waqar H Ahmed
Covered stents are indicated for coronary perforations, but they may seal off major side branches in that process. We report the successful sealing of an ostial left main perforation, induced by a guide catheter in the course of a retrograde approach to treat a chronic total occlusion (CTO) of the right coronary artery (RCA) in a 76year old woman with prior CABG. The implanted Papyrus covered stent, however, overlapped the left main bifurcation and occluded the non-grafted circumflex artery (CX) resulting in acute ischemia...
March 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28303648/subadventitial-techniques-for-chronic-total-occlusion-percutaneous-coronary-intervention-the-concept-of-vessel-architecture
#13
Lorenzo Azzalini, Mauro Carlino, Emmanouil S Brilakis, Minh Vo, Stéphane Rinfret, Barry F Uretsky, Dimitri Karmpaliotis, Antonio Colombo
Despite improvements in guidewire technologies, the traditional antegrade wire escalation approach to chronic total occlusion (CTO) recanalization is successful in only 60-80% of selected cases. In particular, long, calcified, and tortuous occlusions are less successfully approached with a true-to-true lumen approach. Frequently, the guidewire tracks into the subadventitial space, with no guarantee of distal re-entry into the true lumen. The ability to manage the subadventitial space has been a key step in the tremendous improvement in success rates of contemporary CTO percutaneous coronary intervention (PCI), whether operating antegradely or retrogradely...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28296639/impact-of-chronic-total-occlusions-on-revascularization-scores-and-outcome-prediction
#14
Björn Redfors, Tullio Palmerini, Adriano Caixeta, Girma Minalu Ayele, Dominic P Francese, Roxana Mehran, Emmanouil S Brilakis, Ajay J Kirtane, Dimitri Karmpaliotis, Gregg W Stone, Philippe Généreux
OBJECTIVES: To evaluate the contribution of chronic total occlusion (CTO)-related SYNTAX score (SS) to the overall SS for patients with CTO and compare the traditional SS to a simplified variant. The SS algorithm assigns CTO lesions a greater weight (5× points) than non-CTO lesions (50% to <100% diameter stenosis; 2× points). METHODS: We calculated the SS and the simplified SS (2× points also to CTO lesions) for 4356 patients from the angiographic substudy of the Acute Catheterization and Urgent Intervention Triage StrategY (ACUITY) trial...
March 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28296045/one-year-outcomes-after-successful-chronic-total-occlusion-percutaneous-coronary-intervention
#15
W M Wilson, S J Walsh, A Bagnall, A T Yan, C G Hanratty, M Egred, E Smith, K G Oldroyd, M McEntegart, J Irving, H Douglas, J Strange, J C Spratt
We aimed to determine clinical outcomes 1 year after successful chronic total occlusion (CTO) PCI and, in particular, whether use of dissection and re-entry strategies affects clinical outcomes. Hybrid approaches have increased the procedural success of CTO percutaneous coronary intervention (PCI) but longer-term outcomes are unknown, particularly in relation to dissection and re-entry techniques. Data were collected for consecutive CTO PCIs performed by hybrid-trained operators from 7 United Kingdom (UK) centres between 2012 and 2014...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28295660/in-stent-neoatherosclerosis-and-tissue-characteristics-of-restenotic-lesions-following-implantation-of-second-generation-drug-eluting-stents-in-unrestricted-coronary-lesions-optical-frequency-domain-imaging-study
#16
Mahmoud Sabbah, Kazushige Kadota, Azza El-Eraky, Hanan M Kamal, Ahmed-Tageldien Abdellah, Ahmed El Hawary
BACKGROUND: Differences in stent platform, polymer coatings, and antirestenotic drugs among the current in use second-generation drug-eluting stents (G2-DESs) may induce significant variations in neointimal response and vascular healing, which may impact the prevalence of neoatherosclerosis (NA) and morphological appearance of the restenotic tissue. METHODS AND RESULTS: Utilizing Optical frequency domain imaging, two independent reviewers, retrospectively compared the prevalence of neoatherosclerosis (NA), and the morphological differences, and tissue characteristics of 50 G2-DESs in-stent restenosis (ISR) lesions (35 everolimus-eluting stent [22 cobalt-chromium (CoCr), 13 platinum-chromium (PtCr)], and 15 biolimus-eluting stent [BES]) implanted liberally in unrestricted coronary lesions...
March 10, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28292971/selective-replacement-of-mitochondrial-dna-increases-cardioprotective-effect-of-chronic-continuous-hypoxia-in-spontaneously-hypertensive-rats
#17
Jan Neckar, Anna Svatonova, Romana Weissova, Zdenek Drahota, Pavlina Zajickova, Iveta Brabcova, David Kolar, Petra Alanova, Jana Vasinova, Jan Silhavy, Marketa Hlavackova, Katerina Tauchmannova, Marie Milerova, Bohuslav Ostadal, Ludek Cervenka, Jitka Zurmanova, Martin Kalous, Olga Novakova, Jiri Novotny, Michal Pravenec, Frantisek Kolar
Mitochondria play an essential role in improved cardiac ischemic tolerance conferred by adaptation to chronic hypoxia. In the present study, we analyzed effects of continuous normobaric hypoxia (CNH) on mitochondrial functions, including the sensitivity of mitochondrial permeability transition pore (MPTP) to opening, and infarct size in hearts of spontaneously hypertensive rats (SHR) and in conplastic SHR-mtBN strain characterized by the selective replacement of the mitochondrial genome of SHR with that of more ischemia-resistant Brown Norway (BN) strain...
March 14, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28290908/-coronary-angioplasty-and-stenting-in-patients-older-than-80-years-immediate-and-long-term-results
#18
A M Babunashvili, D P Dundua, D S Kartashov, A A Bazarnova, A Yu Korenevich, M E Vetluzhskikh
AIM: to assess immediate and long-term results of coronary angioplasty and stenting in patients older than 80 years - a high risk group in view of the severity of concomitant pathology and extent of coronary atherosclerosis. MATERIAL AND METHODS: We conducted retrospective analysis of data from 167 patients older than 80 years (mean age 81.43+/-2.14 years) subjected to percutaneous coronary intervention from 2006 to 2013 (3.2% from total number of patients). Multivessel involvement was present in 128 patients (76...
July 2016: Kardiologiia
https://www.readbyqxmd.com/read/28288654/non-invasive-in-vivo-imaging-of-cardiac-stem-progenitor-cell-biodistribution-and-retention-after-intracoronary-and-intramyocardial-delivery-in-a-swine-model-of-chronic-ischemia-reperfusion-injury
#19
María Collantes, Beatriz Pelacho, María José García-Velloso, Juán José Gavira, Gloria Abizanda, Itziar Palacios, Luis Rodriguez-Borlado, Virginia Álvarez, Elena Prieto, Margarita Ecay, Eduardo Larequi, Iván Peñuelas, Felipe Prósper
BACKGROUND: The safety and efficacy of cardiac stem/progenitor cells (CSC) have been demonstrated in previous preclinical and clinical assays for heart failure. However, their optimal delivery route to the ischemic heart has not yet been assessed. This study was designed to determine by a non-invasive imaging technique (PET/CT) the biodistribution and acute retention of allogeneic pig CSC implanted by two different delivery routes, intracoronary (IC) and intramyocardial (IM), in a swine preclinical model of chronic ischemia-reperfusion...
March 13, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28287043/healthcare-and-economic-burden-of-adverse-events-among-patients-with-chronic-myelogenous-leukemia-treated-with-bcr-abl1-tyrosine-kinase-inhibitors
#20
Jay Lin, Dinara Makenbaeva, Melissa Lingohr-Smith, Robyn Bilmes
OBJECTIVES: BCR-ABL1 tyrosine kinase inhibitors (TKIs) are established treatments for chronic myelogenous leukemia (CML); however, they are associated with infrequent, but clinically serious adverse events (AEs). The objective of this analysis was to assess healthcare resource utilization and costs associated with AEs, previously identified using the FDA Adverse Event Reporting System (FAERS) in another study, among TKI-treated patients. METHODS: Adult patients with ≥1 inpatient or ≥2 outpatient ICD-9-CM diagnosis codes for CML and ≥1 claim for a TKI treatment between January 1, 2006 and September 30, 2012 were identified from the Commercial and Medicare MarketScan databases...
March 12, 2017: Journal of Medical Economics
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