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Coronary chronic occlusion

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https://www.readbyqxmd.com/read/28227687/characteristic-of-a-force-sensing-guide-wire-for-minimally-invasive-cardiac-surgery
#1
N Stefanova, M Hessinger, T Opitz, R Werthschutzky, N Stefanova, M Hessinger, T Opitz, R Werthschutzky, N Stefanova, M Hessinger, T Opitz
In minimal invasive cardiac surgery (MICS), the surgeon is missing haptic feedback of the guide wire for navigation through the vessels. A wide range of guide wires with various properties and performance characteristics are available to reduce the risk of complications during the intervention. This paper presents a force sensing guide wire for cardiac catheterization, which provides the surgeon a haptic feedback on the guide wire tip. Three conventional wires for the recanalization of chronic total coronary occlusions (CTO) are investigated and general design requirements for the force sensing guide wire are determined...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28218604/everolimus-eluting-bioresorbable-vascular-scaffold-for-treatment-of-complex-chronic-total-occlusions
#2
Jiang Ming Fam, Soledad Ojeda, Roberto Garbo, Azeem Latib, Alessio La Manna, Beatriz Vaquerizo, Marouane Boukhris, Georgios J Vlachojannis, Robert Jan van Geuns, Babu Ezhumalai, Hiroyoshi Kawamoto, Jors van der Sijde, Cordula Felix, Manuel Pan, Roberta Serdoz, Giacomo Giovanni Boccuzzi, Marcella De Paolis, Gennaro Sardella, Corrado Tamburino, Pieter C Smits, Carlo Di Mario, Ashok Seth, Antonio Serra, Antonio Colombo, Patrick Serruys, Alfredo R Galassi, Felix Zijlstra, Nicolas M van Mieghem, Roberto Diletti
AIMS: Bioresorbable vascular scaffolds (BVS) represent a novel therapeutic option for the treatment of coronary artery diseases. The objective of this study is to evaluate the feasibility of BVS implantation in complex chronic total occlusions (CTO). METHODS AND RESULTS: The present report is a multi-centre registry evaluating results after BVS deployment in challenging CTO lesions defined as J-CTO score≥2 (difficult or very difficult). A total of 105 patients were included in the present analysis...
February 21, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28216358/outcomes-of-thoracic-endovascular-aortic-repair-using-aortic-arch-chimney-stents-in-high-risk-patients
#3
Igor Voskresensky, Salvatore T Scali, Robert J Feezor, Javairiah Fatima, Kristina A Giles, Rosamaria Tricarico, Scott A Berceli, Adam W Beck
BACKGROUND: Aortic arch disease is a challenging clinical problem, especially in high-risk patients, in whom open repair can have morbidity and mortality rates of 30% to 40% and 2% to 20%, respectively. Aortic arch chimney (AAC) stents used during thoracic endovascular aortic repair (TEVAR) are a less invasive treatment strategy than open repair, but the current literature is inconclusive about the role of this technology. The focus of this analysis is on our experience with TEVAR and AAC stents...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28214141/feasibility-and-safety-of-same-day-discharge-after-complex-percutaneous-coronary-intervention-using-forearm-approach
#4
Michael Koutouzis, Aris Karatasakis, Emmanouil S Brilakis, Maria Agelaki, Christos Maniotis, Panagiotis Dimitriou, Efstathios Lazaris
OBJECTIVES: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach. BACKGROUND: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study. METHODS: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital...
February 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28197870/intravascular-ultrasound-guidance-of-percutaneous-coronary-intervention-in-ostial-chronic-total-occlusions-a-description-of-the-technique-and-procedural-results
#5
Nicola Ryan, Nieves Gonzalo, Philip Dingli, Oscar Vedia Cruz, Pilar Jiménez-Quevedo, Luis Nombela-Franco, Ivan Nuñez-Gil, María Del Trigo, Pablo Salinas, Carlos Macaya, Antonio Fernandez-Ortiz, Javier Escaned
Inability to cross the lesion with a guidewire is the most common reason for failure in percutaneous revascularization (PCI) of chronic total occlusions (CTOs). An ostial or stumpless CTO is an acknowledged challenge for CTO recanalization due to difficulty in successful wiring. IVUS imaging provides the opportunity to visualize the occluded vessel and to aid guidewire advancement. We review the value of this technique in a single-centre experience of CTO PCI. This series involves 22 patients who underwent CTO-PCI using IVUS guidance for stumpless CTO wiring at our institution...
February 14, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28185704/everolimus-versus-zotarolimus-eluting-stent-following-percutaneous-coronary-chronic-total-occlusion-intervention
#6
Pil Hyung Lee, Min Soo Cho, Seung-Whan Lee, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
BACKGROUND: Although studies have demonstrated comparable efficacy and safety profiles of everolimus- and zotarolimus-eluting stents (EES and ZES, respectively) for a broad spectrum of coronary artery diseases, there is paucity of data concerning their safety and efficacy for coronary chronic total occlusions (CTOs). This study compared the clinical performance of EES and ZES following successful percutaneous coronary intervention for CTOs. METHODS: The cohort included 539 consecutive CTO patients who underwent successful PCI using EES (n=313) and ZES (n=226) between September 2006 and August 2014...
February 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28185396/primary-percutaneous-coronary-intervention-of-native-chronic-total-occlusions-to-treat-st-elevation-myocardial-infarction-secondary-to-acute-vein-graft-occlusion
#7
Pierre Deharo, Julian W Strange, Abdul Mozid
Primary percutaneous coronary intervention (PCI) is the treatment modality of choice in patients presenting with ST elevation myocardial infarction (STEMI). Clinical outcomes have dramatically improved with the wide adoption of primary PCI in patients with STEMI because of acute thrombotic native coronary artery occlusion. However, patients with prior coronary artery bypass graft (CABG) surgery who present with STEMI because of acute saphenous vein graft (SVG) occlusion continue to have worse outcomes because of poor acute and long-term results of SVG stenting...
February 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28183464/transradial-coronary-interventions-for-complex-chronic-total-occlusions
#8
Yutaka Tanaka, Noriaki Moriyama, Tomoki Ochiai, Takuma Takada, Kazuki Tobita, Koki Shishido, Kazuya Sugitatsu, Futoshi Yamanaka, Shingo Mizuno, Masato Murakami, Junya Matsumi, Saeko Takahashi, Takeshi Akasaka, Shigeru Saito
OBJECTIVES: The aims of this study were to assess whether the transradial approach can be applied to treat complex chronic total occlusion (CTO) and to determine the predictors of transradial percutaneous coronary intervention (PCI) failure. BACKGROUND: Consistent data on the outcomes of transradial PCI for treating CTO are scarce. METHODS: Consecutive patients who were not receiving hemodialysis and had undergone PCI for CTO were enrolled...
February 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28171874/predicting-successful-recanalization-in-patients-with-native-coronary-chronic-total-occlusion-the-busan-cto-score
#9
Cai De Jin, Moo Hyun Kim, Soo Jin Kim, Kwang Min Lee, Tae Hyung Kim, Young-Rak Cho, Victor L Serebruany
BACKGROUND: The optimal strategy to manage chronic total occlusion (CTO) remains unclear. The Japanese CTO multicenter registry (J-CTO) score is an established tool for predicting successful recanalization. However, it does not take into account nonangiographic predictors for final technique success. In the present study, we designed and tested a scoring model called the Busan single-center CTO registry (B-CTO) score combining clinical and angiographic characteristics to predict successful CTO recanalization in Korean patients...
February 8, 2017: Cardiology
https://www.readbyqxmd.com/read/28169213/long-term-clinical-outcomes-of-patients-with-coronary-chronic-total-occlusion-treated-with-percutaneous-coronary-intervention-versus-medical-therapy-according-to-presence-of-diabetes-mellitus
#10
Ki Hong Choi, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Hyeon-Cheol Gwon, Sang Hoon Lee, Seung-Hyuk Choi
AIMS: The aim of this study was to compare the long-term clinical outcomes of patients with chronic total occlusion (CTO) treated with percutaneous coronary intervention (PCI) versus medical therapy (MT) according to the presence of diabetes mellitus. METHODS AND RESULTS: A total of 845 patients without diabetes and 702 patients with diabetes were included from the Samsung Medical Center CTO registry. The inverse probability of treatment weighted (IPTW) method was used to adjust for confounding factors...
February 7, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28169091/predictors-of-excess-patient-radiation-exposure-during-chronic-total-occlusion-coronary-intervention-insights-from-a-contemporary-multicentre-registry
#11
Georgios E Christakopoulos, Georgios Christopoulos, Dimitri Karmpaliotis, Khaldoon Alaswad, Robert W Yeh, Farouc A Jaffer, Michael R Wyman, William L Lombardi, Muhammad Nauman J Tarar, J Aaron Grantham, David E Kandzari, Nicholas Lembo, Jeffrey W Moses, Ajay J Kirtane, Manish Parikh, Philip Green, Matthew Finn, Santiago Garcia, Anthony H Doing, Raja Hatem, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: High patient radiation dose during chronic total occlusion (CTO) percutaneous coronary intervention (PCI) might lead to procedural failure and radiation skin injury. METHODS: We examined the association between several clinical and angiographic variables on patient air kerma (AK) radiation dose among 748 consecutive CTO PCIs performed at 9 experienced US centres between May 2012 and May 2015. RESULTS: The mean age was 65 ± 10 years, 87% of patients were men, and 35% had previous coronary artery bypass graft surgery (CABG)...
November 11, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28164433/coronary-artery-aneurysm-after-implantation-of-a-bioresorbable-vascular-scaffold-case-report-and-literature-review
#12
Su-Kiat Chua, Jun-Jack Cheng
A 55-year-old man underwent successful percutaneous coronary intervention for the middle left circumflex artery with a 3.5 × 28-mm bioresorbable vascular scaffold (BVS). At 18 months, follow-up coronary angiography showed ectatic change with aneurysm formation over the BVS. Optical coherence tomography revealed absence of strut continuity at the aneurysm site, in the middle of the BVS. A literature review identified nine patients with intrascaffold aneurysm, including the present patient, which developed 6-32 months after BVS implantation...
February 6, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28164017/alcohol-septal-ablation-for-hypertrophic-obstructive-cardiomyopathy-in-a-patient-with-a-chronic-total-occlusion-of-the-right-coronary-artery-beware-of-collateral-damage
#13
Quentin de Hemptinne, Fabien Picard, Philippe L L'Allier
Alcohol septal ablation (ASA) is an effective semi-invasive alternative to surgical myectomy in selected patients for the management of severely symptomatic and drug-refractory hypertrophic obstructive cardiomyopathy (HOCM). One contraindication of this procedure is the presence of collateral flow originating from the target septal perforator to a remote myocardial territory. In such circumstances, ethanol injection could cause remote non-target myocardial necrosis in the collateralized territory. Percutaneous revascularization of the collateralized vessel prior to ASA might cope with this contraindication by restoring normal antegrade flow in the occluded artery...
February 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28163422/transcatheter-pulmonary-valve-perforation-using-chronic-total-occlusion-wire-in-pulmonary-atresia-with-intact-ventricular-septum
#14
Shweta Bakhru, Shilpa Marathe, Manish Saxena, Sudeep Verma, Rajan Saileela, Tapan K Dash, Nageswara Rao Koneti
BACKGROUND: Perforation of pulmonary valve using radiofrequency ablation in pulmonary atresia with intact ventricular septum (PA IVS) is a treatment of choice. However, significant cost of the equipment limits its utility, especially in the developing economies. OBJECTIVE: To assess the feasibility, safety, and efficacy of perforation of pulmonary valve using chronic total occlusion (CTO) wires in patients with PA IVS as an alternative to radiofrequency ablation...
January 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28161258/pathology-of-chronic-total-occlusion-in-bare-metal-versus-drug-eluting-stents-implications-for-revascularization
#15
Hiroyoshi Mori, Christoph Lutter, Kazuyuki Yahagi, Emanuel Harari, Robert Kutys, David R Fowler, Elena Ladich, Michael Joner, Renu Virmani, Aloke V Finn
OBJECTIVES: The aim of this study was to explore the pathology of in-stent chronic total occlusion (IS-CTO) in bare-metal (BMS) versus drug-eluting stents (DES). BACKGROUND: Despite a relatively high prevalence of IS-CTO, little is known about the underlying etiology and histopathologic characteristics of the occlusion. METHODS: From CVPath Institute's stent registry of human native coronary arteries, the authors identified 56 lesions (32 BMS and 24 DES) from 54 patients with IS-CTO...
January 25, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28160245/lipoprotein-a-hyperlipoproteinemia-as-cause-of-chronic-spinal-cord-ischemia-resulting-in-progressive-myelopathy-successful-treatment-with-lipoprotein-apheresis
#16
Franz Heigl, Reinhard Hettich, Erich Mauch, Reinhard Klingel, Cordula Fassbender
High concentrations of lipoprotein(a) (Lp(a)) represent an important independent and causal risk factor associated with adverse outcome in atherosclerotic cardiovascular disease (CVD). Effective Lp(a) lowering drug treatment is not available. Lipoprotein apheresis (LA) has been proven to prevent cardiovascular events in patients with Lp(a)-hyperlipoproteinemia (Lp(a)-HLP) and progressive CVD. Here we present the course of a male patient with established peripheral arterial occlusive disease (PAOD) at the early age of 41 and coronary artery disease (CAD), who during follow-up developed over 2 years a progressive syndrome of cerebellar and spinal cord deficits against the background of multifactorial cardiovascular risk including positive family history of CVD...
February 3, 2017: Clinical Research in Cardiology Supplements
https://www.readbyqxmd.com/read/28155111/association-between-duration-of-coronary-occlusion-and-high-intensity-signal-on-t1-weighted-magnetic-resonance-imaging-among-patients-with-angiographic-total-occlusion
#17
Kenji Matsumoto, Shoichi Ehara, Takao Hasegawa, Mikumo Sakaguchi, Kenei Shimada
OBJECTIVES: To evaluate the association between duration of the coronary occlusion and high-intensity signal (HIS) on noncontrast T1-weighted imaging using a 1.5-T magnetic resonance imager among patients with angiographic coronary total occlusion. METHODS: The signal intensity of the coronary target area divided by the signal intensity of the left ventricular muscle near the target area at each site (TMR) was measured. Areas with a TMR >1.0 were defined as HIS...
February 2, 2017: European Radiology
https://www.readbyqxmd.com/read/28149318/efficacy-and-safety-of-tornus-catheter-in-percutaneous-coronary-intervention-of-hard-or-balloon-uncrossable-chronic-total-occlusion
#18
Mohsen Mohandes, Sergio Rojas, Jordi Guarinos, Francisco Fernández, Xavier Oliva, Marianela Noueched, Alfredo Bardaji
BACKGROUND: Balloon advancement and dilation through chronic total occlusion segment could be challenging in some cases after successful wire crossing. The purpose of this study was to evaluate efficacy and safety of Tornus catheter (Asahi Intecc; Aichi, Japan) in percutaneous coronary intervention of chronic total occlusion in hard or balloon-uncrossable chronic total occlusion. METHODS: The present study is a retrospective and descriptive analysis of 14 hard or balloon-uncrossable chronic total occlusions treated percutaneously in our catheterization laboratory (cath lab)...
July 2016: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/28145879/late-double-barrel-lumen-following-successful-cto-pci-using-the-crossboss-stingray-system
#19
James Roy, David Rees, David Ramsay, James Weaver
There remains limited randomized controlled trials on long-term clinical outcomes after chronic total occlusion percutaneous coronary intervention (CTO-PCI). New techniques involving dissection of the subintimal space and reentry into the true lumen increase success rates in CTO-PCI. However, their longer-term safety and efficacy remain unknown and poorly studied. We present a case of double-lumen formation seen at 1 year post CTO-PCI using subintimal dissection reentry with late restoration of major side branches...
February 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28145875/novel-crossing-system-for-chronic-total-occlusion-recanalization-first-in-man-experience-with-the-soundbite-crossing-system
#20
Andrew Benko, Simon Bérubé, Christopher E Buller, Steven Dion, Louis-Philippe Riel, Martin Brouillette, Philippe Généreux
Chronic total occlusion (CTO) lesions are frequent in patients with peripheral and coronary artery disease, and are associated with a higher risk of adverse events, including mortality, decreased quality of life, and increased health-care costs. Percutaneous intervention of CTO lesions has been associated with a lower procedural success rate, and current dedicated CTO devices may be of limited use for non-CTO experts, and associated with increased intraprocedural complication rates. The SoundBite Crossing System (SoundBite Medical Solutions, Inc) is a newly-developed device using shockwaves (short-duration, high-amplitude pressure pulses) delivered to the tip of guidewire to facilitate penetration of the proximal cap and crossing of the occlusion...
February 2017: Journal of Invasive Cardiology
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