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Chronic total occlusions

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https://www.readbyqxmd.com/read/27923460/comparison-of-characteristics-and-complications-in-men-versus-women-undergoing-chronic-total-occlusion-percutaneous-intervention
#1
Vinoda Sharma, William Wilson, William Smith, Margaret McEntegart, Keith Oldroyd, Novalia Sidik, Alan Bagnall, Mohaned Egred, John Irving, Julian Strange, Thomas Johnson, Simon Walsh, Colm Hanratty, James Spratt
Gender differences exist in clinical outcomes after routine percutaneous coronary intervention (PCI), but studies reporting such outcomes after chronic total occlusion (CTO) PCI are limited. We assessed the characteristics and outcomes of female patients undergoing CTO PCI. We retrospectively analyzed a dedicated national (United Kingdom) prospective CTO database from 2011 to 2015 for outcomes and characteristics of female patients undergoing CTO PCI (unmatched and propensity matched). Female patients constituted 20...
November 16, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27922810/impact-of-chronic-total-occlusion-revascularization-attempts-on-subsequent-clinical-outcomes
#2
Ahmad Jabbar, Georgios Christopoulos, Aris Karatasakis, Omar M Jeroudi, Georgios E Christakopoulos, Abdallah El Sabbagh, Barbara Danek, Judit Karacsonyi, Michele Roesle, Bavana V Rangan, Jerrold Grodin, Michael Luna, Shuaib Abdullah, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: We examined a contemporary, unselected cohort of patients with coronary chronic total occlusions (CTOs) to determine the impact of CTO revascularization on long-term outcomes. METHODS: We retrospectively assessed the impact of CTO revascularization on clinical outcomes of consecutive patients found to have a CTO during coronary angiography performed at our institution during 2011 and 2012. The primary endpoint was the incidence of a major adverse cardiac event (MACE, defined as a composite of death, myocardial infarction, stroke, and target-vessel revascularization [TVR])...
December 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27922805/near-infrared-spectroscopy-analysis-of-coronary-chronic-total-occlusions
#3
Georgios E Christakopoulos, Judit Karacsonyi, Barbara Anna Danek, Aris Karatasakis, Aya Alame, Pratik Kalsaria, Atif Mohammed, Michele Roesle, Bavana V Rangan, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVE: To examine the presence and localization of lipid-core plaque (LCP) in coronary vessels with chronic total occlusions (CTOs) using near-infrared spectroscopy (NIRS). METHODS: NIRS imaging was performed after guidewire crossing of the occlusion in 15 patients with CTOs. LCP was defined as ≥2 adjacent 2 mm yellow blocks on the block chemogram. We also measured the maximum lipid-core burden index (LCBI) in a 4 mm length of artery (maxLCBI4mm). Large LCP was defined as maxLCBI4mm ≥500...
December 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27917651/the-correlation-between-lymphocyte-monocyte-ratio-and-coronary-collateral-circulation-in-stable-coronary-artery-disease-patients
#4
Alparslan Kurtul, Mustafa Duran
AIM: Coronary collateral circulation (CCC) has an important impact on cardiovascular prognosis and well-developed CCC is associated with better clinical outcomes. We investigated whether lymphocyte/monocyte ratio (LMR) has an association with CCC in patients with stable coronary artery disease (SCAD). METHODS: The study population consisted of 245 patients with SCAD. Patients were classified into a poor CCC group (Rentrop grades 0/1, n = 87), or good CCC group (Rentrop grades 2/3, n = 158)...
December 5, 2016: Biomarkers in Medicine
https://www.readbyqxmd.com/read/27916048/-the-impact-of-red-blood-cell-distribution-width-on-outcome-of-elective-percutaneous-coronary-intervention-in-non-anemia-patients
#5
X M Liu, J Z Dong, X H Liu, J P Kang, T Y Luo, Y Guan, T Y Dai, Y Zhang, R Bai, X Du, C S Ma
Objective: Previous studies have revealed that the red blood cell distribution width (RDW) was associated with long-term prognosis in patients undergoing percutaneous coronary intervention (PCI). However, they did not exclude patients with anemia. This study, thus, investigated the association between RDW and prognosis in non-anemia patients. Methods: A total of 2 732 patients underwent elective PCI from July 2009 to September 2011 were enrolled in the study. These patients were divided into two groups based on their baseline median RDW levels: low RDW group (RDW<12...
December 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/27910082/impact-of-the-presence-of-chronically-occluded-coronary-artery-on-long-term-prognosis-of-patients-with-acute-st-segment-elevation-myocardial-infarction
#6
Maciej Lesiak, Monika Cugowska, Aleksander Araszkiewicz, Marek Grygier, Małgorzata Pyda, Włodzimierz Skorupski, Przemysław Mitkowski, Magdalena Łanocha, Stefan Grajek
BACKGROUND: Multivessel disease (MVD) is a significant risk factor in patients with acute ST-segment elevation myocardial infarction (STEMI). Whether the presence of chronic total occlusion (CTO) poses an additional hazard is still unknown. The objective of this study was to evaluate the impact of CTO on survival in STEMI patients. METHODS: The study group consisted of 836 STEMI patients treated with primary percutaneous coronary intervention (PCI). MVD was diagnosed in 52...
December 2, 2016: Cardiology Journal
https://www.readbyqxmd.com/read/27894264/optical-coherence-tomography-findings-after-longitudinal-ablation-for-an-underexpanded-stent-in-a-heavily-calcified-lesion-a-case-report
#7
Masahiro Koide, Keiji Inoue, Akiko Matsuo, Hiroshi Fujita
BACKGROUND: Heavy coronary artery calcification is responsible for stent underexpansion, which is associated with increased in-stent restenosis. Here we report a case in which optical coherence tomography (OCT) demonstrated that the metal component of an underexpanded stent previously implanted in a heavy calcified lesion had been completely removed after ablation with rotational atherectomy. CASE PRESENTATION: An 83-year-old man with exertional angina was referred to our hospital...
November 29, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27890863/the-first-clinical-experience-with-a-novel-locking-microcatheter-in-chronic-coronary-total-occlusions
#8
Simon J Wilson, Joren Maeremans, Simon J Walsh, Colm G Hanratty, Markus Meyer-Gessner, Jo Dens, Evald H Christiansen, Alexander Bufe, James C Spratt
AIMS: A novel 'locking' microcatheter has been developed to address residual failure modes in chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The aim of this study was to report the first clinical experience of this device. METHODS AND RESULTS: The microcatheter was assessed prospectively in 92 unselected CTO cases across 6 European sites. Overall technical success was 85.9% (79/92) and 97.5% for patients with a J- CTO score of <3 (39/40)...
November 29, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27890859/long-term-outcome-of-patients-with-chronic-total-coronary-occlusion-treated-by-percutaneous-coronary-intervention-in-diabetics-and-non-diabetics
#9
Francesca Sanguineti, Philippe Garot, Stephen O'Connor, Yusuke Watanabe, Marco Spaziano, Thierry Lefèvre, Thomas Hovasse, Hakim Benamer, Thierry Unterseeh, Bernard Chevalier, Marie Claude Morice, Yves Louvard
AIMS: Despite technical advancements, long-term outcomes after Chronic Total Occlusion (CTO) recanalization remain a subject of debate, especially in diabetic patients. METHODS AND RESULTS: Between 2004 and 2012, 1,320 consecutive patients underwent PCI for CTO, 27.4 % (362/1320) of whom were diabetics. We compared cardiac death, target lesion revascularisation (TLR), myocardial infarction (MI) and combined Myocardial Adverse Cardiac Events (MACE) in patients with successful versus failed PCI (median follow up 4...
November 29, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27888750/medium-platelet-volume-as-a-noninvasive-predictor-of-chronic-total-occlusion-in-non-infarct-artery-in-patients-with-non-st-segment-elevation-myocardial-infarction-and-multivessel-coronary-artery-disease
#10
Mateusz Tajstra, Michał Hawranek, Piotr Desperak, Aneta Ciślak, Marek Gierlotka, Andrzej Lekston, Lech Poloński, Mariusz Gąsior
BACKGROUND: Chronic total occlusion (CTO) in a noninfarct-related artery (non-IRA) is an independent predictor of mortality in non-ST elevation myocardial infarction (NSTEMI). Mean platelet volume (MPV) is associated with cardiovascular events in NSTEMI. Little is known about the predictors of non-IRA-CTO in patients with NSTEMI. The purpose of this study was to evaluate the relationship between the presence of non-IRA-CTO with MPV level in patients with NSTEMI and multivessel coronary artery disease (MVCAD)...
November 14, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27887799/procedural-and-longer-term-outcomes-of-wire-versus-device-based-antegrade-dissection-and-re-entry-techniques-for-the-percutaneous-revascularization-of-coronary-chronic-total-occlusions
#11
Lorenzo Azzalini, Rustem Dautov, Emmanouil S Brilakis, Soledad Ojeda, Susanna Benincasa, Barbara Bellini, Aris Karatasakis, Jorge Chavarría, Bavana V Rangan, Manuel Pan, Mauro Carlino, Antonio Colombo, Stéphane Rinfret
BACKGROUND: There are few data regarding the procedural and follow-up outcomes of different antegrade dissection/re-entry (ADR) techniques for chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We compiled a multicenter registry of consecutive patients undergoing ADR-based CTO PCI at four high-volume specialized institutions. Patients were divided according to the specific ADR technique used: subintimal tracking and re-entry (STAR), limited antegrade subintimal tracking (LAST), or device-based with the CrossBoss/Stingray system (Boston Scientific, Marlborough, MA)...
November 16, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27884362/e-cart-electrocautery-assisted-re-entry-of-an-aorto-ostial-right-coronary-artery-chronic-total-occlusion-first-in-man
#12
William Nicholson, James Harvey, Rajiv Dhawan
No abstract text is available yet for this article.
November 28, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27882189/successful-treatment-of-resistant-hypertension-by-means-of-chronic-renal-artery-occlusion-revascularization-in-a-fragile-patient
#13
Laura Spezia, Simone Perandini, Raffaele Augelli, Giovanni Puppini, Stefania Montemezzi
BACKGROUND: Renal artery stenosis is a common cause of secondary hypertension refractory to medical therapy. Percutaneous angioplasty along with metallic stent placement has been described as an effective treatment for revascularization of the renal artery. CASE REPORT: A 54-year-old woman affected by paranoid schizophrenia with a history of hypertension and chronic renal failure due to renal artery occlusion was treated by endovascular recanalization and stent placement that resulted in improvement of renal function and control of hypertension...
2016: Polish Journal of Radiology
https://www.readbyqxmd.com/read/27875729/-seesaw-balloon-wire-cutting-technique-is-superior-to-tornus-catheter-in-balloon-uncrossable-chronic-total-occlusions
#14
Jingyi Xue, Jianqiang Li, Hongjun Wang, Li Sheng, Yongtai Gong, Danghui Sun, Shuang Li, Weimin Li, Dingyu Wang, Yue Li
BACKGROUND: Inability to advance a balloon is a well-recognized cause leading to a failure in recanalization of chronic total occlusions (CTOs) despite successfully passing a guidewire. A few techniques and devices have been introduced to facilitate balloon passage, especially the use of Tornus catheter. However, complex manipulation, expensive cost, and availability limit the application of these methods. This study was to evaluate the efficiency and safety of "seesaw balloon-wire cutting" technique in comparison with Tornus catheter for balloon uncrossable CTOs...
November 2, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27875725/association-of-cxcr4-expression-with-coronary-collateralization-in-patients-with-chronic-total-coronary-occlusion-a-nested-case-control-study
#15
Chun Yang, Wenjin Zhu, Xiu Han, Aiqun Ma, Ling Bai, Feng Xu
OBJECTIVE: CXCR4 signaling contributes to the development and progression of neovascularization. The objective of this study was to investigate whether CXCR4 expression in peripheral CD34+ cells associated with the coronary collateralization (CC) in patients with chronic total coronary occlusion (CTO). METHODS AND RESULTS: We measured CXCR4 expression in peripheral CD34+ cells and assessed its relation with CC in a nested case-control study including 78 cases and 78 matched controls aged 38-69years, assessed in January 2011 to December 2012 and with at least 1year of follow-up before the index date...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27873169/evaluation-for-the-efficacy-and-safety-of-the-crosser-catheter-as-a-cto-crossing-device-and-a-flossing-device
#16
Michinao Tan, Kazushi Urasawa, Ryoji Koshida, Takuya Haraguchi, Shunsuke Kitani, Yuya Nakagawa, Yasumi Igarashi, Katsuhiko Sato
The Crosser catheter is a unique device that facilitates antegrade intraluminal recanalization by high-frequency vibration energy and cavitation. We used this device not only as a chronic total occlusion (CTO) crossing device, but also as a flossing device in stenotic lesions and we also evaluated the efficacy of this device when used with both the "Crosser preceding" and the "Guidewire preceding" in CTOs. Complications related to this device were investigated, too. We retrospectively analyzed a total of 90 consecutive patients with peripheral artery disease in the femoropopliteal artery and below-the-knee artery (BTA)...
November 21, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/27867284/ekosonic-thrombolysis-as-a-therapeutic-adjunct-in-venous-occlusive-disease
#17
D S Zaghlool, R W Franz, J Jenkins
The use of ultrasound waves in conjunction with local thrombolysis may accelerate clot resolution and serve as an important therapeutic adjunct in the treatment of venous occlusive disease. Our goal was to provide a larger sample population over a 5-year period to evaluate our experience with the EkoSonic endovascular system (EKOS, EKOS Corporation, Bothell, WA). We suspected that ultrasound-accelerated thrombolysis (UAT) using EKOS would provide excellent thrombolysis and midterm patency rates with minimal thrombolytic complications...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27867143/survival-after-percutaneous-coronary-intervention-for-chronic-total-occlusion-in-elderly-patients
#18
Aurel Toma, Catherine Gebhard, Michael Gick, Ademaj Fadil, Barbara E Stähli, Kambis Mashayekhi, Miroslaw Ferenc, Franz-Josef Neumann, Heinz Joachim Buettner
AIMS: Few data are available on outcomes of percutaneous coronary intervention (PCI) for coronary chronic total occlusions (CTO) in very elderly patients in the drug-eluting stent (DES) era. We investigated long-term survival in a single-center cohort of elderly patients following CTO PCI using DES. METHODS AND RESULTS: Consecutive 2002 patients who underwent PCI of a CTO at our center between 01/2005 and 12/2013 were followed for a median of 2.6 years (interquartile range 1...
November 22, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27862880/feasibility-and-1-year-outcomes-of-subintimal-revascularization-with-supera-%C3%A2-stenting-of-long-femoropopliteal-occlusions-in-critical-limb-ischemia-the-supersub-study
#19
Luis M Palena, Larry J Diaz-Sandoval, Enrico Sultato, Cesare Brigato, Alessandro Candeo, Enrico Brocco, Marco Manzi
BACKGROUND: Stent-based revascularization of long femoro-popliteal (FP) lesions has been mainly studied in claudicants and compromised by restenosis and stent fractures. The Supera(®) stent's biomimetic design allows enhanced fracture resistance. Data for Supera(®) stenting to treat long chronic total occlusions (CTOs) in patients with critical limb ischemia (CLI), are scarce. OBJECTIVE: To assess long-term outcomes of subintimal revascularization with Supera(®) stenting, for long FP CTOs in patients with CLI...
November 12, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27860111/coronary-artery-spatial-distribution-of-chronic-total-occlusions-insights-from-a-large-us-registry
#20
Santiago Garcia, M Chadi Alraies, Aris Karatasakis, Demetris Yannopoulos, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul P Patel, John Bahadorani, Judit Karacsonyi, Pratik Kalsaria, Barbara Danek, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVE: To assess the spatial distribution of chronic total occlusions (CTOs) within the coronary arteries and describe procedural strategies and outcomes during CTO percutaneous coronary intervention (PCI). BACKGROUND: Acute occlusions due to plaque rupture tend to cluster within the proximal third of the coronary artery. METHODS: We examined the clinical and procedural characteristics of 1,348 patients according to lesion location within the coronary tree...
November 10, 2016: Catheterization and Cardiovascular Interventions
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