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Coronary total chronic occlusion

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https://www.readbyqxmd.com/read/29051975/impact-of-lesion-complexity-on-long-term-vascular-response-to-cobalt-chromium-everolimus-eluting-stent-five-year-follow-up-optical-coherence-tomography-study
#1
Shoichi Kuramitsu, Shinjo Sonoda, Tomohiro Shinozaki, Hiroyuki Jinnouch, Yoshitaka Muraoka, Takenori Domei, Makoto Hyodo, Shinichi Shirai, Kenji Ando, Yutaka Otsuji
The impact of lesion complexity on long-term vascular response to cobalt-chromium everolimus-eluting stent (CoCrEES) remains unclear. We sought to evaluate them using optical coherence tomography (OCT). A total of 47 patients with 58 lesions treated only with CoCrEES and no target-vessel events within 5 years after implantation were prospectively enrolled and underwent 5-year follow-up OCT. Quantitative parameters and qualitative characteristics of the neointima were evaluated using multilevel logistic or linear regression models with random effects at three levels: lesion, cross-section (CS), and strut...
October 19, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29044291/preprocedural-leucocyte-count-predicts-risk-in-patients-with-coronary-chronic-total-occlusion
#2
Catherine Gebhard, Aurel Toma, Zhao Min, Barbara E Stähli, Kambis Mashayekhi, Michael Gick, Miroslaw Ferenc, Heinz Joachim Büttner, Franz-Josef Neumann
Background As technologies of percutaneous coronary intervention (PCI) for coronary chronic total occlusions (CTO) have improved, great uncertainty exists regarding patient selection and long-term benefit of CTO-PCI. Given that white blood cell (WBC) count has been associated with cardiovascular risk, we hypothesized that the latter might provide incremental prognostic value in patients undergoing CTO-PCI. Methods and Results Our study population consisted of 1,262 consecutive patients (76.3% males, mean age of 67...
October 10, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29035846/current-perspectives-and-practices-on-chronic-total-occlusion-percutaneous-coronary-interventions
#3
Siddharth M Patel, Rohan V Menon, M Nicolas Burke, Farouc A Jaffer, Robert W Yeh, Minh Vo, Dimitri Karmpaliotis, Lorenzo Azzalini, Mauro Carlino, Kambis Mashayekhi, Alfredo R Galassi, Stephane Rinfret, Stephen G Ellis, Mitul Patel, Bavana V Rangan, Aris Karatasakis, Barbara A Danek, Judit Karacsonyi, Erica Resendes, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: We sought to examine contemporary perspectives and practices on chronic total occlusion (CTO) percutaneous coronary intervention (PCI). BACKGROUND: The frequency and success of CTO-PCI have been increasing in recent years. METHODS: An online questionnaire was created and distributed to cardiologists within the United States and internationally. RESULTS: A total of 1149 responses were obtained. The United States (n = 845; 73...
October 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29024010/imaging-behind-occluded-areas-with-an-iatrogenic-perforated-balloon-a-safe-practical-and-simple-new-method-of-visualizing-the-distal-lumen-in-total-occlusion
#4
Yakup Balaban, Osman Bektaş, Adil Bayramoğlu, Hasan A Gümrükçüoğlu, Ali H Kayışoğlu
OBJECTIVE: In the present study, we investigated the effectiveness and reliability of a new method that reveals whether guidewire advanced distal to the lesion is in the lumen in patients with acute (ATO) or chronic coronary total occlusion (CTO). METHODS: Forty-one patients with symptomatic ATO and 22 patients with CTO who were admitted into our catheterization laboratory between January 2016 and March 2017 were included. In patients in whom antegrade filling could not be demonstrated after passing 0...
October 10, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29021271/impact-of-hemodialysis-on-procedural-outcomes-of-percutaneous-coronary-intervention-for-chronic-total-occlusion-insights-from-the-japanese-multicenter-registry
#5
Tatsuya Nakachi, Shun Kohsaka, Masahisa Yamane, Toshiya Muramatsu, Atsunori Okamura, Yoshifumi Kashima, Shunsuke Matsuno, Masami Sakurada, Mikihiko Kijima, Masaki Tanabe, Maoto Habara
BACKGROUND: Among patients treated with percutaneous coronary intervention for chronic total occlusion (CTO-PCI), patients on long-term hemodialysis are at significantly high risk for cardiovascular mortality and morbidity. However, clinical or angiographic predictors that might aid in better patient selection remain unclear. We aimed to assess the acute impact of hemodialysis in patients who underwent CTO-PCI. METHODS AND RESULTS: The Retrograde Summit registry is a multicenter, prospective registry of patients undergoing CTO-PCI at 65 Japanese centers...
October 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29020367/clinical-outcomes-of-state-of-the-art-percutaneous-coronary-revascularization-in-patients-with-de-novo-three-vessel-disease-1-year-results-of-the-syntax-ii-study
#6
Javier Escaned, Carlos Collet, Nicola Ryan, Giovanni Luigi De Maria, Simon Walsh, Manel Sabate, Justin Davies, Maciej Lesiak, Raul Moreno, Ignacio Cruz-Gonzalez, Stephan P Hoole, Nick Ej West, J J Piek, Azfar Zaman, Farzin Fath-Ordoubadi, Rodney H Stables, Clare Appleby, Nicolas van Mieghem, Robert Jm van Geuns, Neal Uren, Javier Zueco, Pawel Buszman, Andres Iñiguez, Javier Goicolea, David Hildick-Smith, Andrzej Ochala, Dariusz Dudek, Colm Hanratty, Rafael Cavalcante, Arie Pieter Kappetein, David P Taggart, Gerrit-Anne van Es, Marie-Angèle Morel, Ton de Vries, Yoshinobu Onuma, Vasim Farooq, Patrick W Serruys, Adrian P Banning
Aims: To investigate if recent technical and procedural developments in percutaneous coronary intervention (PCI) significantly influence outcomes in appropriately selected patients with three-vessel (3VD) coronary artery disease. Methods and results: The SYNTAX II study is a multicenter, all-comers, open-label, single arm study that investigated the impact of a contemporary PCI strategy on clinical outcomes in patients with 3VD in 22 centres from four European countries...
August 26, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28986404/predictors-of-successful-chronic-total-occlusion-percutaneous-coronary-interventions-a-systematic-review-and-meta-analysis
#7
Nelson Wang, Jordan Fulcher, Nishan Abeysuriya, Mark Adams, Sean Lal
OBJECTIVE: The aim of this study was to identify positive and negative predictors of technical and clinical success for percutaneous coronary intervention (PCI) of chronic total occlusions (CTO). METHODS: We conducted a systematic review and meta-analysis of studies published between 2000 and 2016 analysing rates of CTO PCI success with respect to demographic and angiographic characteristics. Crude ORs and 95% CIs for each predictor were calculated using a random effects model...
October 6, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28984768/the-safety-and-feasibility-of-guidezilla-catheter-in-complex-coronary-interventions-and-an-observational-study
#8
Jianying Ma, Lei Hou, Juying Qian, Lei Ge, Feng Zhang, Shufu Chang, Rende Xu, Qing Qin, Junbo Ge
The monorail Guidezilla guide extension catheter was designed to provide additional backup and facilitate device delivery in percutaneous coronary intervention (PCI) for complex coronary anatomy such as chronic total occlusion (CTO), extreme vessel tortuosity, diseased bypass grafts, and anomalous coronary arteries, among others.The present retrospective, single-center study included 188 consecutive patients who underwent PCI using the Guidezilla catheter from March 2015 to August 2016. Study outcomes were rates of target lesion crossing success, procedural success, and complications...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28980430/initial-results-of-a-first-in-human-study-on-the-plasmawire%C3%A2-system-a-new-radiofrequency-wire-for-recanalization-of-chronic-total-occlusions
#9
Daitaro Kanno, Etsuo Tsuchikane, Kenya Nasu, Osamu Katoh, Yoshifumi Kashima, Umihiko Kaneko, Tsutomu Fujita, Yoriyasu Suzuki, Takahiko Suzuki
OBJECTIVES: To examine the safety, efficacy, and efficiency of the PlasmaWire(TM) System to recanalize coronary chronic total occlusions (CTO) using controlled ablation inside the CTO. BACKGROUND: The PlasmaWire(TM) System is a new bipolar radiofrequency (RF) wire system utilizing plasma-mediated ablation to facilitate wire crossing in CTOs. Two independent PlasmaWire(TM) wires are used in tandem for channel creation by applying RF energy between the tips so as to localize the ablation...
October 5, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28976619/comparison-of-long-term-mortality-according-to-obesity-in-patients-with-successful-percutaneous-chronic-total-occlusion-interventions-using-drug-eluting-stents
#10
Ki-Bum Won, Hyuck-Jun Yoon, Sang-Gon Lee, Yun-Kyeong Cho, Chang-Wook Nam, Seung-Ho Hur, Seung-Whan Lee, Pil-Hyung Lee, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Young-Hak Kim, Cheol-Whan Lee, Seong-Wook Park, Seung-Jung Park
OBJECTIVE: To evaluate the long-term mortality according to obesity in patients with chronic total occlusion (CTO) lesions after successful percutaneous coronary intervention (PCI). BACKGROUND: Despite the potential impact of coronary revascularization and lesion severity on the obesity paradox, the long-term survival according to obesity in CTO patients after successful PCI has been unknown. METHODS AND RESULTS: Between January 2003 and September 2014, we examined 1,172 consecutive Korean patients with 1,190 CTO lesions who underwent successful drug-eluting stent (DES) implantation in two tertiary academic medical centers...
May 8, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28974664/percutaneous-stenting-for-unprotected-left-main-chronic-total-occlusion
#11
Nagaraja Moorthy, Rangaraj Ramalingam, K Subramanyam, Shivanand S Patil, Manjunath C Nanjappa
PCI of a left main coronary artery chronic total occlusion followed by PCI of the right coronary artery was performed in a patient refusing CABG surgery.
October 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28966325/rotational-atherectomy-followed-by-drug-coated-balloon-dilation-for-left-main-in-stent-restenosis-in-the-setting-of-acute-coronary-syndrome-complicated-with-right-coronary-chronic-total-occlusion
#12
Jun Shiraishi, Keisuke Shoji, Takashi Yanagiuchi, Masaki Yashige, Akira Shikuma, Daisuke Ito, Masayoshi Kimura, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo, Takahisa Sawada
An 83-year-old man presented with recurrent acute coronary syndrome (ACS) at the left main coronary artery (LMCA) complicated with ostial chronic total occlusion (CTO) in the right coronary artery (RCA) (RCA-CTO). At the first LMCA-ACS approximately 1 year earlier, he had undergone LMCA-crossover stenting with a biolimus-eluting stent in the presence of RCA-CTO. At the second LMCA-ACS, we angiographically confirmed severe in-stent restenosis in the distal LMCA, in addition to angled severe stenosis in the just proximal LCx, and performed primary PCI for the LMCA bifurcation lesion under intra-aortic balloon pumping support...
September 30, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28964751/feasibility-and-safety-of-augmented-reality-glass-for-computed-tomography-assisted-percutaneous-revascularization-of-coronary-chronic-total-occlusion-a-single-center-prospective-pilot-study
#13
Maksymilian P Opolski, Artur Debski, Bartosz A Borucki, Adam D Staruch, Cezary Kepka, Jakub K Rokicki, Bartosz Sieradzki, Adam Witkowski
BACKGROUND: Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) may be facilitated by projection of coronary computed tomography angiography (CTA) datasets in the catheterization laboratory. There is no data on the feasibility and safety outcomes of CTA-assisted CTO PCI using a wearable augmented-reality glass. METHODS: A total of 15 patients scheduled for elective antegrade CTO intervention were prospectively enrolled and underwent preprocedural coronary CTA...
September 21, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28963749/chronic-total-occlusion-in-non-infarct-related-artery-is-associated-with-increased-short-and-long-term-mortality-in-patients-with-st-segment-elevation-acute-myocardial-infarction-complicated-by-cardiogenic-shock-from-the-credo-kyoto-ami-registry
#14
Hiroki Watanabe, Takeshi Morimoto, Hiroki Shiomi, Tetsuma Kawaji, Yutaka Furukawa, Yoshihisa Nakagawa, Kenji Ando, Kazushige Kadota, Takeshi Kimura
OBJECTIVES: We aimed to investigate the effect of chronic total occlusion (CTO) in non-infarct-related artery (IRA) on short- and long-term mortality in ST-segment elevation myocardial infarction (STEMI) patients complicated by cardiogenic shock (CS). BACKGROUND: Previous studies show contradictory results about the clinical effect of CTO in non-IRA on short-term mortality in STEMI patients with CS. METHODS: From the CREDO-Kyoto AMI registry enrolling 5429 patients, the current study population consisted of 313 STEMI patients with multivessel disease complicated by CS who underwent primary PCI for the nonleft main coronary artery culprit lesion within 24 hr after onset...
September 30, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28959098/the-efficacy-and-safety-of-using-extension-catheters-in-complex-coronary-interventions-a-single-center-experience
#15
Mu-Shiang Huang, Chun-I Wu, Fu-Hsiang Chang, Hsien-Yuan Chang, Po-Tseng Lee, Ju-Yi Chen, Wen-Huang Lee, Chih-Chan Lin, Shih-Hung Chan, Ping-Yen Liu, Cheng-Han Lee
BACKGROUND: The extension catheter was originally developed to facilitate stent delivery to challenging lesions. We evaluated the efficacy and safety of using an extension catheter in patients undergoing percutaneous coronary interventions (PCI). METHODS: Two interventional cardiologists reviewed the records of all consecutive patients who, between November 2011 and October 2015, had undergone PCI with a GuideLiner or Heartrail ST-01 extension catheter. Clinical demographics, vessel characteristics, procedural details, and outcomes were recorded...
September 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28952133/change-in-the-distal-vessel-luminal-diameter-following-chronic-total-occlusion-revascularization
#16
Usaid K Allahwala, Michael R Ward, Ravinay Bhindi
Coronary chronic total occlusions (CTO) occur when there is complete, or near complete occlusion of a vessel, angiographically appreciated by the presence of a collateral circulation with late filling of the occluded vessel. With restoration of anterograde blood flow there is alteration in vascular wall stress which may influence distal vessel size. We sought to determine if the distal vessel size changes following revascularization of the CTO. We retrospectively reviewed patients who underwent successful CTO revascularization and who subsequently underwent repeat angiography...
September 26, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28944620/intracoronary-snaring-of-the-retrograde-guidewire-how-to-overcome-extreme-takeoff-angles-in-chronic-total-occlusion-percutaneous-coronary-intervention
#17
Lorenzo Azzalini, Luciano Candilio, Mauro Carlino, Antonio Colombo
Extreme angulation of coronary artery takeoff represents a challenge for wiring and device advancement in percutaneous coronary intervention (PCI). This anatomic feature is particularly adverse in cases of chronic total occlusion (CTO) of the ostial-proximal segment of the target vessel. In this setting, the retrograde approach can help getting access to the occlusion. However, difficulties might arise at the critical step of wire externalization, due to the need to overcome the extreme ostial angle. Here, we describe a case of successful CTO PCI of the proximal circumflex artery, which presented an extreme angle at its takeoff...
September 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28943496/clinical-implications-of-periprocedural-myocardial-injury-in-patients-undergoing-percutaneous-coronary-intervention-for-chronic-total-occlusion-role-of-antegrade-and-retrograde-crossing-techniques
#18
Aurel Toma, Barbara Stähli, Cathérine Gebhard, Michael Gick, Jan Minners, Kambis Mashayekhi, Alexandre Avran, Miroslaw Ferenc, Heinz Joachim Buettner, Franz-Josef Neumann
AIMS: Periprocedural myocardial injury (PMI) is frequently observed afterpercutaneous coronary interventions (PCI) for chronic total occlusion (CTO). Weinvestigated the prognostic impact of PMI with the antegrade or the retrogradecrossing technique. METHODS AND RESULTS: A total of 1'909 patients undergoing CTO PCI were stratifiedaccording to the presence/absence of PMI (elevation of cardiac troponin T [cTnT] >5x 99th percentile of normal), and divided according to tertiles of the difference betweenpeak and baseline cTnT within 24 hours (ΔcTnT)...
September 26, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28940388/prognostic-value-of-the-age-creatinine-and-ejection-fraction-score-for-non-infarct-related-chronic-total-occlusion-revascularization-after-primary-percutaneous-intervention-in-acute-st-elevation-myocardial-infarction-patients-a-retrospective-study
#19
Jie Deng, Xiaozeng Wang, Yana Shi, Xin Zhao, Yaling Han
OBJECTIVE: It is not known if ACEF scores could evaluate the prognosis of recanalization of non-infarct-related coronary arteries (non-IRA) with chronic total occlusions (CTO) in patients who successfully underwent primary PCI. The objective of the current study was to assess the prognostic value of ACEF scores in acute ST-segment elevation myocardial infarction (STEMI) patients with non-IRA CTO after successful primary PCI. METHODS: There were 2952 STEMI patients who underwent successful primary PCI from January 2006 to December 2014 in our hospital, among them 377 patients had a non-IRA CTO lesion...
September 20, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28939719/clinical-characteristics-and-management-of-coronary-artery-perforations-a-single-center-11-year-experience-and-practical-overview
#20
Miguel E Lemmert, Rutger J van Bommel, Roberto Diletti, Jeroen M Wilschut, Peter P de Jaegere, F Zijlstra, Joost Daemen, Nicolas M Van Mieghem
BACKGROUND: Coronary artery perforation (CAP) is a potentially lethal complication of percutaneous coronary intervention. We report on the incidence, clinical characteristics, and management of iatrogenic coronary perforations based on an 11-year single-center experience. METHODS AND RESULTS: From February 9, 2005, through November 20, 2016, 150 CAP cases were identified from our percutaneous coronary intervention database of 21 212 procedures (0.71%). Mean age of CAP patients was 66±11 years, and 62...
September 22, 2017: Journal of the American Heart Association
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