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Chronic total occlusions

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https://www.readbyqxmd.com/read/29331435/complications-of-chronic-total-occlusion-percutaneous-coronary-intervention-subepicardial-hematoma
#1
Punag Divanji, Kendrick Shunk
A 67-year-old man with coronary artery disease and previous coronary underwent successful Guideliner reverse CART percutaneous coronary intervention of a chronic total occlusion of the right coronary artery. He later developed evidence of myocardial ischemia, and imaging, including angiogram, echocardiogram, and cardiac computed tomography revealing active dye extravasation from the previously normal RV marginal branches, in addition to a large subepicardial hematoma. Despite these dramatic findings, the patient remained hemodynamically stable and pain-free, with resolving ECG changes...
December 30, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29330258/chronic-total-occlusion-percutaneous-coronary-intervention-evidence-and-controversies
#2
REVIEW
Peter Tajti, Emmanouil S Brilakis
No abstract text is available yet for this article.
January 12, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29326812/endovascular-laser-treatment-of-incompetent-saphenous-veins-using-the-1470%C3%A2-nm-diode-laser-and-radial-fiber
#3
Georgios Vourliotakis, Georgios Sahsamanis, Paschalis Evagelidis, Christina Aivatidi
Objectives: To assess the technical success, complications, and patients' quality of life (QoL) after treatment of chronic venous disease (CVD) using the 1470 nm radial fiber laser. Methods: A total of 170 patients with chronic venous disease, classified as C2 to C4 according to CEAP classification, were treated for incompetent greater (GSV) and small (SSV) saphenous veins, using the 1470 nm radial fiber laser and application of tumescent anesthesia. Additional phlebectomies were performed through stab microincisions, while 11 patients further underwent sclerotherapy intraoperatively...
January 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29318422/correction-to-morphological-characteristics-of-chronic-total-occlusion-predictors-of-different-strategies-for-long-segment-femoral-arterial-occlusions
#4
Li-Ming Wei, Yue-Qi Zhu, Pei-Lei Zhang, Fang Liu, Hai-Tao Lu, Jun-Gong Zhao
The original version of this article unfortunately contained mistakes. The legends to Figs. 2-4 were incorrectly interchanged. The correct versions are given below. The original article has been corrected.
January 9, 2018: European Radiology
https://www.readbyqxmd.com/read/29315803/short-term-and-long-term-clinical-outcomes-of-rotational-atherectomy-in-resistant-chronic-total-occlusion
#5
Wei-Chieh Huang, Hsin-I Teng, Wan-Leong Chan, Tse-Min Lu
OBJECTIVES: To evaluate the short- and long-term clinical outcomes of RA in CTO coronary intervention. BACKGROUND: The application of rotational atherectomy (RA) may improve the success rate of percutaneous recanalization of chronic total occlusion (CTO) with heavy calcification. METHODS: From January 2011 to September 2014, we enrolled 285 patients with CTO who underwent successful percutaneous coronary intervention (PCI). Resistant CTO lesions were defined as those with heavy calcifications as well as those that no devices are able to pass after guide wire crossing...
January 8, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29314641/chronic-total-occlusion-does-anti-platelet-choice-impact-outcomes
#6
EDITORIAL
Wassim Shatila, Zvonimir Krajcer
Chronic total occlusion (CTO) is associated with worse outcomes compared to non CTO percutaneous coronary intervention (PCI). CTO might be associated with vasomotor dysfunction Ticagrelor is a novel P2Y12 inhibitor that increases local adenosine The TIGER-BVS trial plans to assess the impact of using ticagrelor vs. clopidogrel on vasomotor activity and outcomes after successful CTO PCI.
January 1, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29314567/antegrade-fenestration-and-re-entry-a-new-controlled-subintimal-technique-for-chronic-total-occlusion-recanalization
#7
Mauro Carlino, Lorenzo Azzalini, Satoru Mitomo, Antonio Colombo
OBJECTIVES: To describe and evaluate the efficacy of a novel antegrade dissection/re-entry (ADR) technique, called antegrade fenestration and re-entry (AFR), for chronic total occlusions (CTO) percutaneous coronary intervention (PCI). BACKGROUND: The widespread adoption of ADR is limited by several technical, logistic, and financial factors. Therefore, novel ADR techniques are needed. METHODS: AFR consists in creating multiple fenestrations of the dissection flap separating the false and true lumen...
January 4, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29314563/subadventitial-stenting-around-occluded-stents-a-bailout-technique-to-recanalize-in-stent-chronic-total-occlusions
#8
Lorenzo Azzalini, Aris Karatasakis, James C Spratt, Péter Tajti, Robert F Riley, Luiz F Ybarra, Stefan P Schumacher, Susanna Benincasa, Barbara Bellini, Luciano Candilio, Satoru Mitomo, Peter Henriksen, Francisco Hidalgo, Leo Timmers, Adriaan O Kraaijeveld, Pierfrancesco Agostoni, James Roy, David R Ramsay, James C Weaver, Paul Knaapen, Alexander Nap, Boris Starcevic, Soledad Ojeda, Manuel Pan, Khaldoon Alaswad, William L Lombardi, Mauro Carlino, Emmanouil S Brilakis, Antonio Colombo, Stéphane Rinfret, Kambis Mashayekhi
OBJECTIVES: To evaluate the outcomes of subadventitial stenting (SS) around occluded stents for recanalizing in-stent chronic total occlusions (IS-CTOs). BACKGROUND: There is little evidence on the outcomes of SS for IS-CTO. METHODS: We examined the outcomes of SS for IS-CTO PCI at 14 centers between July 2011 and June 2017, and compared them to historical controls recanalized using within-stent stenting (WSS). Target-vessel failure (TVF) on follow-up was the endpoint of this study, and was defined as a composite of cardiac death, target-vessel myocardial infarction, and target-vessel revascularization...
January 4, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29314289/long-term-outcomes-post-chronic-total-occlusion-intervention-implications-of-completeness-of-revascularization
#9
Pravin K Goel, Roopali Khanna, C M Pandey, Fauzia Ashfaq
BACKGROUND: Long term clinical outcomes post chronic total occlusion (CTO) intervention may depend not only on CTO success/failure alone but also on Completeness of revascularization. OBJECTIVES: To determine long term outcomes post CTO intervention and relate them to both success versus failure and Complete Revascularization (CR) versus Incomplete Revascularization (IR). METHODS: Consecutive patients taken up for CTO intervention with at-least one CTO vessel between Jan 2006 to Dec 2015 were included...
January 4, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29311284/collateral-channel-size-and-tortuosity-predict-retrograde-percutaneous-coronary-intervention-success-for-chronic-total-occlusion
#10
Ching-Chang Huang, Chih-Kuo Lee, Shih-Wei Meng, Chi-Sheng Hung, Ying-Hsien Chen, Mao-Shin Lin, Chih-Fan Yeh, Hsien-Li Kao
BACKGROUND: There is little evidence on how to select an interventional collateral channel (CC) in retrograde chronic total occlusion (CTO) percutaneous coronary intervention. We aimed to identify independent angiographic predictors of CC tracking and technical success in retrograde CTO percutaneous coronary intervention. METHODS AND RESULTS: From January 2012 to December 2015, a total of 216 consecutive retrograde CTO percutaneous coronary intervention attempts by a high-volume operator in a tertiary university-affiliated hospital were enrolled...
January 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29306468/mid-term-outcomes-of-chronic-total-occlusion-percutaneous-coronary-intervention-with-subadventitial-vs-intraplaque-crossing-a-systematic-review-and-meta-analysis
#11
Aris Karatasakis, Barbara A Danek, Judit Karacsonyi, Lorenzo Azzalini, Mauro Carlino, Stéphane Rinfret, Minh Vo, Bavana V Rangan, M N Burke, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: Some reports have demonstrated increased risk with subadventitial chronic total occlusion (CTO) crossing, whereas others suggest equipoise between subadventitial and intraplaque crossing techniques. We sought to clarify the effect of subadventitial lesion crossing on mid-term outcomes of CTO percutaneous coronary intervention (PCI). METHODS: We conducted a systematic review and meta-analysis of studies reporting post-discharge outcomes after CTO PCI performed via subadventitial vs...
February 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29305825/slender-transradial-iliac-artery-stenting-using-a-4-5%C3%A2-french-guiding-sheath
#12
Norihiko Shinozaki, Takashi Minowa, Tsutomu Murakami, Yohei Ohno, Masataka Nakano, Toshiharu Fujii, Gaku Nakazawa, Fuminobu Yoshimachi, Yuji Ikari
We previously reported safety and usefulness of transradial iliac artery stenting using 6 Fr guiding sheath. However, radial artery occlusion was a major limitation of this procedure. We analyzed the safety and utility of slender transradial iliac artery stenting using a 4.5 Fr guiding sheath to prevent radial artery occlusion. We performed transradial iliac artery stenting in left radial artery, using a 4.5 Fr sheath incorporating a shaft length of 110 cm, for 34 lesions in 29 patients. Transradial intervention was attempted at the discretion of the operator...
January 5, 2018: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/29289358/association-of-stress-test-risk-classification-with-health-status-after-chronic-total-occlusion-angioplasty-from-the-outcomes-patient-health-status-and-efficiency-in-chronic-total-occlusion-hybrid-procedures-open-cto-study
#13
Adam C Salisbury, James Sapontis, John T Saxon, Kensey L Gosch, William L Lombardi, Dimitri Karmpaliotis, Jeffery W Moses, Mohammed Qintar, Ajay J Kirtane, John A Spertus, David J Cohen, J Aaron Grantham
Stress testing is endorsed by the American College of Cardiology/American Heart Association Appropriate Use Criteria to identify appropriate candidates for Chronic Total Occlusion (CTO) Percutaneous Coronary Intervention (PCI). However, the relation between stress test risk classification and health status after CTO PCI is not known. We studied 449 patients in the 12-center OPEN CTO registry who underwent stress testing before successful CTO PCI, comparing outcomes of patients with low-risk (LR) versus intermediate to high-risk (IHR) findings...
December 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29276418/peripheral-artery-occlusive-disease-among-patients-with-chronic-myeloid-leukemia-receiving-tyrosine-kinase-inhibitors-a-cross-sectional-case-control-study
#14
Thanawat Rattanathammethee, Adisak Tantiworawit, Ekarat Rattarittamrong, Chatree Chai-Adisaksopha, Sasinee Hantrakool, Arintaya Phrommintikul, Wanwarang Wongcharoen, Siriluck Gunaparn, Lalita Norasetthada
Background: There were some reports of peripheral artery occlusive disease (PAOD) associated with nilotinib usage in chronic myeloid leukemia (CML). These complications in other tyrosine kinase inhibitors are revealed as unknown. Materials and methods: We determined the prevalence of PAOD in patients with CML as compared with matched-control population by cross-sectional case-control study. Peripheral artery occlusive disease was screened by ankle-brachial index (ABI)...
2017: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/29275602/-long-term-outcomes-of-implanting-drug-eluting-stents-for-unprotected-left-main-coronary-artery-disease-patients-with-left-ventricular-systolic-dysfunction
#15
Y Pan, Q Qiu, W H Ren, X P Yu, Q Li, X J Ren
Objective: To analyze the clinical characteristics and prognosis of implanting drug-eluting stents (DES) for unprotected left main (ULM) coronary artery disease patients with left ventricular systolic dysfunction (LVSD). Methods: A total of 511 ULM coronary artery disease patients who underwent DES implantation from January 2005 to January 2012 in Department of Cardiology, Beijing Anzhen Hospital were included in the study. Based on left ventricular ejection fraction (LVEF), the patients were divided into three groups: LVEF≤40% (n=104), 41%≤LVEF≤49% (n=137), and LVEF≥50% (n=270)...
December 12, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29266736/incidence-predicting-factors-and-clinical-outcomes-of-periprocedural-myocardial-infarction-after-percutaneous-coronary-intervention-for-chronic-total-occlusion-in-the-era-of-new-generation-drug-eluting-stents
#16
Jin-Ho Kim, Byeong-Keuk Kim, Seunghwan Kim, Chul-Min Ahn, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang
OBJECTIVE: This study aimed to examine predictors and clinical outcomes of periprocedural myocardial infarction (PMI) after chronic total occlusion (CTO) intervention. BACKGROUND: There are limited data on the clinical implications of PMI after CTO intervention in the new-generation drug-eluting stent (DES) era. METHODS: We enrolled 337 patients who underwent CTO intervention and met the study criteria. We evaluated the incidence and predictors of PMI, defined as an increase in creatine kinase-MB ≥3× the upper limit of normal (ULN) after intervention and compared the occurrence rates of major adverse cardiac and cerebrovascular events (MACCE, defined as the composite of cardiac death, myocardial infarction, stent thrombosis, target-vessel revascularization, or cerebrovascular accidents) between the PMI and non-PMI groups...
December 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29266669/the-side-base-technique-combined-side-branch-anchor-balloon-and-balloon-assisted-sub-intimal-entry-to-resolve-ambiguous-proximal-cap-chronic-total-occlusions
#17
James Roy, Jonathan Hill, James C Spratt
Failure to penetrate the proximal cap or cross with equipment remains the most frequent cause of procedural failure in CTO PCI. In the "BASE" technique concerns were raised over the risk of proximal side branch loss. We here describe the evolution of this technique and highlight examples where the sub-intimal space was accessed proximal to the occlusion by using the side branch. This technique can be of use both in resolving proximal cap ambiguity and also in cases where there is difficulty crossing a resistant proximal cap...
December 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29257736/management-of-coronary-chronic-total-occlusion
#18
REVIEW
Jaikirshan Khatri, Mouin Abdallah, Stephen Ellis
Percutaneous coronary intervention (PCI) for coronary artery chronic total occlusion (CTO) is an important treatment to be used in conjunction with non-CTO PCI, coronary artery bypass grafting, and optimal medical therapy to achieve complete revascularization in patients with coronary artery disease.
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29251204/directional-atherectomy-with-antirestenotic-therapy-vs-drug-coated-balloon-angioplasty-alone-for-common-femoral-artery-atherosclerotic-disease
#19
Konstantinos Stavroulakis, Arne Schwindt, Giovanni Torsello, Efthymios Beropoulis, Arne Stachmann, Christiane Hericks, Leonie Bollenberg, Theodosios Bisdas
PURPOSE: To report an experience using directional atherectomy (DA) with antirestenotic therapy (DAART) in the form of drug-coated balloon (DCB) angioplasty vs DCB angioplasty alone in common femoral artery (CFA) occlusive lesions. METHODS: A retrospective review was conducted of 47 consecutive patients (mean age 71 years; 26 men) treated between October 2011 and July 2016 using either DCB angioplasty alone (n=26) or DAART (n=21) for CFA lesions. The majority of patients had lifestyle-limiting claudication (14 DCB and 15 DAART)...
December 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29240587/reclaiming-autologous-amputated-tissue-for-limb-salvage-of-a-diabetic-foot-burn-with-underlying-critical-limb-ischemia
#20
Catherine N Tchanque-Fossuo, Andrew M Wishy, Kaitlyn I M West, David L Dawson, Sara E Dahle, John G Carson
BACKGROUND: Diabetes mellitus is a worldwide pandemic that impacts more than 387 million people, with 29 million individuals affected in the United States alone. Diabetic patients have a 25% lifetime risk of developing a diabetic foot ulcer (DFU). Having a DFU is associated with a risk of recurrence approaching 70%. In addition, 1 in 6 patients with DFU will have a lower-limb amputation, with an associated increase in mortality ranging from 47% to 70%. Therefore, limb salvage is critical in patients with DFU...
January 2018: Advances in Skin & Wound Care
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