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CTO LESIONS TREATMENT

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https://www.readbyqxmd.com/read/29345588/the-role-of-percutaneous-coronary-intervention-in-the-treatment-of-chronic-total-occlusions-rationale-and-review-of-the-literature
#1
Harsh Agrawal, Richard Lange, Ruben Montanez, Soma Wali, Khan Omar Mohammad, Subrata Kar, Mohamed Teleb, Debabrata Mukherjee
BACKGROUND: Chronic total occlusion (CTO) of a coronary artery is defined as an occluded segment with no antegrade flow and a known or estimated duration of at least 12 weeks. OBJECTIVE: We considered the current literature describing the indications and clinical outcomes for de-novo CTO- percutaneous coronary intervention (PCI), and discuss the role of CTO-PCI and future directions for this procedure. METHOD: Databases (PubMed, the Cochrane Library, Embase, EBSCO, Web of Science, and CINAHL were searched and relevant studies of CTO-PCI were selected for review...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29315803/short-term-and-long-term-clinical-outcomes-of-rotational-atherectomy-in-resistant-chronic-total-occlusion
#2
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/29306468/mid-term-outcomes-of-chronic-total-occlusion-percutaneous-coronary-intervention-with-subadventitial-vs-intraplaque-crossing-a-systematic-review-and-meta-analysis
#3
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/29224054/lesion-characteristics-and-procedural-outcomes-of-re-attempted-percutaneous-coronary-interventions-for-chronic-total-occlusion
#4
Masaki Tanabe, Kenji Kodama, Kohei Asada, Takeo Kunitomo
This study was performed to investigate lesion characteristics and procedural outcomes of re-attempted percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). Prior failure of percutaneous revascularization of CTO has been identified as an independent predictor of failure at subsequent attempts. However, procedural outcomes of re-attempted PCI for CTO have not been elucidated. We evaluated lesion characteristics and procedural outcomes in 310 consecutive patients undergoing CTO-PCI, and compared the results between re-attempted (n = 59) and initial procedures (n = 251)...
December 9, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29220345/a-randomized-trial-of-bifurcation-stenting-technique-in-chronic-total-occlusions-percutaneous-coronary-intervention
#5
Vitaly I Baystrukov, Evgeniy I Kretov, Marouane Boukhris, Alexander G Osiev, Igor O Grazhdankin, Alexey V Biryukov, Hatem Najjar, Vladimir V Verin, Dmitriy D Zubarev, Ivan A Naryshkin, Alexander V Bogachev-Prokophiev, Kambis Mashayekhi, Alfredo R Galassi, Alexey A Prokhorikhin
BACKGROUND: The optimal strategy to treat bifurcation lesions (BFLs) in a percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) remains unknown. AIMS: We sought to assess whether T-provisional or mini-crush is appropriate for BFLs within CTO vessels. PATIENTS AND METHODS: From January 2011 to December 2013, patients who underwent successful CTO guidewire crossing and with a BFL within the CTO target vessel were enrolled prospectively and assigned randomly to either T-provisional stenting or the mini-crush technique for BFL treatment...
January 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29183248/assessing-the-landscape-of-percutaneous-coronary-chronic-total-occlusion-treatment-in-belgium-and-luxembourg-the-belgian-working-group-on-chronic-total-occlusions-bwgcto-registry
#6
Joren Maeremans, Peter Kayaert, Yoann Bataille, Johan Bennett, Claudiu Ungureanu, Steven Haine, Tom Vandendriessche, Jeroen Sonck, Benjamin Scott, Patrick Coussement, Daniël Dendooven, Bruno Pereira, Peter Frambach, Luc Janssens, Philippe Debruyne, Carlos Van Mieghem, Emanuele Barbato, Kristoff Cornelis, Francis Stammen, Frederic De Vroey, Steven Vercauteren, Benny Drieghe, Adel Aminian, Jan Debrauwere, Stéphane Carlier, Mark Coosemans, Bert Van Reet, Peter Vandergoten, Jo Andre Dens
BACKGROUND: Important developments in materials, devices, and techniques have improved outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI), and resulted in a growing interest in CTO-PCI. The Belgian Working Group on Chronic Total Occlusions (BWGCTO) working group aims to assess the evolution within the CTO-PCI landscape over the next years. METHODS: From May 2016 onwards, patients undergoing CTO-PCI were included in the BWGCTO registry by 15 centres in Belgium and Luxemburg...
November 28, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/29137819/vascular-response-and-healing-profile-of-everolimus-eluting-bioresorbable-vascular-scaffolds-for-percutaneous-treatment-of-chronic-total-coronary-occlusions-a-one-year-optical-coherence-tomography-analysis-from-the-ghost-cto-registry
#7
Alessio La Manna, Eligio Miccichè, Guido D'Agosta, Gabriel Tensol Rodrigues Pereira, Guilherme Ferragut Attizzani, Piera Capranzano, Davide Capodanno, Corrado Tamburino
BACKGROUND: Bioresorbable vascular scaffolds (BVS) have been heralded with potential benefits that are especially desired in long lesions, including chronic total occlusions (CTOs). Procedural feasibility and mid-term outcomes of BVS in CTOs have been reported. However, there is still a paucity of data regarding the vascular and healing response to BVS in CTOs evaluated by optical coherence tomography (OCT). METHODS: This study included prospectively 21 patients who had a CTO lesion treated with a BVS...
November 8, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29128364/one-versus-2-stent-strategy-for-the-treatment-of-bifurcation-lesions-in-the-context-of-a-coronary-chronic-total-occlusion-a-multicenter-registry
#8
Soledad Ojeda, Lorenzo Azzalini, Jorge Chavarría, Antonio Serra, Francisco Hidalgo, Susanna Benincasa, Livia L Gheorghe, Roberto Diletti, Miguel Romero, Barbara Bellini, Alejandro Gutiérrez, Javier Suárez de Lezo, Francisco Mazuelos, José Segura, Mauro Carlino, Antonio Colombo, Manuel Pan
INTRODUCTION AND OBJECTIVES: There is little evidence on the optimal strategy for bifurcation lesions in the context of a coronary chronic total occlusion (CTO). This study compared the procedural and mid-term outcomes of patients with bifurcation lesions in CTO treated with provisional stenting vs 2-stent techniques in a multicenter registry. METHODS: Between January 2012 and June 2016, 922 CTO were recanalized at the 4 participating centers. Of these, 238 (25...
November 8, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29105577/comparative-assessment-of-patient-outcomes-with-intraluminal-or-subintimal-crossing-of-infrainguinal-peripheral-artery-chronic-total-occlusions
#9
Ananya Kondapalli, Haekyung Jeon-Slaughter, Hua Lu, Hao Xu, Houman Khalili, Anand Prasad, Ehrin J Armstrong, Emmanouil S Brilakis, Subhash Banerjee
This study compares procedural complications and clinical outcomes between subintimal crossing versus intraluminal crossing during endovascular treatment of infrainguinal peripheral artery chronic total occlusions (CTO). We identified 1335 CTO interventions in 1001 patients from the multicenter Excellence in Peripheral Artery Disease (XLPAD) registry from January 2005 to October 2015. Outcomes included 30-day and 12-month all-cause death, non-fatal myocardial infarction or stroke, peripheral artery stent, or vessel, thrombosis (ST), need for any target limb endovascular or surgical revascularization, target limb major amputation and procedural complications...
November 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/29097079/one-versus-2-stent-strategy-for-the-treatment-of-bifurcation-lesions-in-the-context-of-a-coronary-chronic-total-occlusion-a-multicenter-registry
#10
Soledad Ojeda, Lorenzo Azzalini, Jorge Chavarría, Antonio Serra, Francisco Hidalgo, Susanna Benincasa, Livia L Gheorghe, Roberto Diletti, Miguel Romero, Barbara Bellini, Alejandro Gutiérrez, Javier Suárez de Lezo, Francisco Mazuelos, José Segura, Mauro Carlino, Antonio Colombo, Manuel Pan
INTRODUCTION AND OBJECTIVES: There is little evidence on the optimal strategy for bifurcation lesions in the context of a coronary chronic total occlusion (CTO). This study compared the procedural and mid-term outcomes of patients with bifurcation lesions in CTO treated with provisional stenting vs 2-stent techniques in a multicenter registry. METHODS: Between January 2012 and June 2016, 922 CTO were recanalized at the 4 participating centers. Of these, 238 (25...
October 30, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29068125/novel-use-of-cutting-balloon-to-treat-subintimal-hematomas-during-chronic-total-occlusion-interventions
#11
Minh N Vo, Emmanouil S Brilakis, J Aaron Grantham
Contemporary chronic total occlusion (CTO) percutaneous coronary interventional (PCI) techniques are increasingly dependent upon dissection and reentry techniques (DARTs) especially for long occluded lesions. DARTs can result in compressive hematomas during CTO interventions and traditional treatment with balloon angioplasty and/or coronary stenting are often suboptimal and may extend the hematoma distally. We describe the novel use of a cutting balloon to "express" these compressive hematomas and restore antegrade coronary blood flow...
October 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28966322/the-structure-of-a-chronic-total-occlusion-and-its-safe-treatment-in-a-patient-with-chronic-thromboembolic-pulmonary-hypertension
#12
Shun Minatsuki, Masaru Hatano, Hisataka Maki, Jiro Ando, Issei Komuro
A pouching defect, which is a type of angiographic classification in chronic thromboembolic pulmonary hypertension (CTEPH), is equivalent to a chronic total occlusion (CTO). Thus far, treating CTO involves high risk of the lung bleeding and is difficult because the structure and treating strategy have not been clarified, yet treating it has great potential to improve hemodynamic status and ventilation perfusion mismatch. Here, we describe a case of successfully treated the CTO. In this case, we treated it safely by two balloon pulmonary angiography (BPA) sessions...
October 21, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28966155/one-year-clinical-outcomes-after-unrestricted-implantation-of-absorb-bioresorbable-scaffold-rai-registry
#13
Alfonso Ielasi, Bernardo Cortese, Elisabetta Moscarella, Bruno Loi, Giuseppe Tarantini, Attilio Varricchio, Francesco Pisano, Alessandro Durante, Giampaolo Pasquetto, Alessandro Colombo, Gabriele Tumminello, Luciano Moretti, Paolo Calabrò, Pietro Mazzarotto, Maurizio Tespili, Donatella Corrado, Giuseppe Steffenino
AIMS: to assess the outcomes following Absorb bioresorbable scaffold (BVS) implantation in an unrestricted clinical practice according to an "on-label" versus "off-label" indication. METHODS AND RESULTS: RAI is a prospective registry, investigating the BVS performance in different lesions subsets. No specific exclusion criteria were applied. Co-primary end-points were target lesion revascularization (TLR) and definite/probable scaffold thrombosis (ScT) at one-year...
October 3, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28803800/-ping-pong-technique-for-treating-a-balloon-uncrossable-chronic-total-occlusion
#14
Michael Koutouzis, Grigorios Avdikos, Georgios Nikitas, Theodoros Zografos, Ioannis Tsiafoutis, Maria Agelaki, Efstathios Lazaris
Balloon uncrossable lesions are a well-known challenge during chronic total occlusion (CTO) interventions. The technique of using two different catheters into the same coronary artery, the so-called "ping-pong" technique, is a technique described for treating complications during percutaneous coronary intervention (PCI), like perforations or rotational atherectomy burr entrapment. We describe a case where the "ping-pong" technique was successfully used to facilitate treatment of a balloon uncrossable CTO lesion...
July 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28797429/early-procedural-and-health-status-outcomes-after-chronic-total-occlusion%C3%A2-angioplasty-a-report-from-the-open-cto-registry-outcomes-patient-health-status-and-efficiency-in-chronic-total-occlusion-hybrid-procedures
#15
James Sapontis, Adam C Salisbury, Robert W Yeh, David J Cohen, Taishi Hirai, William Lombardi, James M McCabe, Dimitri Karmpaliotis, Jeffrey Moses, William J Nicholson, Ashish Pershad, R Michael Wyman, Anthony Spaedy, Stephen Cook, Parag Doshi, Robert Federici, Craig R Thompson, Steven P Marso, Karen Nugent, Kensey Gosch, John A Spertus, J Aaron Grantham
OBJECTIVES: This study sought to accurately describe the success rate, risks, and patient-reported benefits of contemporary chronic total occlusion (CTO) percutaneous coronary intervention (PCI). BACKGROUND: In light of the evolving techniques to successfully revascularize CTO lesions, there remains a compelling need to more accurately quantify the success rates, risks, and benefits of these complex procedures. METHODS: Using a uniquely comprehensive, core-lab adjudicated, single-arm, multicenter registry of 1,000 consecutive patients undergoing CTO PCI by the hybrid approach, we evaluated the technical success rates, complication rates, and raw and adjusted health status benefits at 1 month among successfully as compared to unsuccessfully treated patients...
August 14, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28766879/bivalirudin-in-percutaneous-coronary-intervention-for-chronic-total-occlusion-a-single-center-pilot-study
#16
Chenguang Li, Rende Xu, Yi Shen, Yuxiang Dai, Feng Zhang, Jianying Ma, Lei Ge, Juying Qian, Junbo Ge
BACKGROUND: Bivalirudin has been reported to be an alternative to unfractionated heparin (UFH) for anticoagulation during percutaneous coronary intervention (PCI) and associated with less bleeding risk. However, the feasibility of bivalirudin during PCI of chronic total occlusion lesions (CTO) remains unknown. OBJECTIVE: To evaluate the efficacy and safety of bivalirudin versus UFH in CTO PCI. METHODS: In this prospective and randomized controlled trial in single center, CTO patients with high bleeding risk were randomized to treatment with bivalirudin (bolus 0...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28766400/transvenous-intravascular-ultrasound-guided-endovascular-treatment-for-chronic-total-occlusion-of-infrainguinal-arteries
#17
Yasuhiro Takahashi, Taisuke Sato, Hirotake Okazaki, Ayaka Nozaki, Masato Matsushita, Masataka Kamiya, Wataru Shimizu
PURPOSE: To investigate the 1-year outcomes of transvenous intravascular ultrasound (IVUS)-guided endovascular therapy (EVT) for chronic total occlusion (CTO) of the lower extremity arteries. METHODS: Transvenous IVUS-guided EVT was performed in 44 patients (50 limbs) with CTO of the femoropopliteal arteries or tibioperoneal trunk. Treatment involved crossing a guidewire through the CTO under the guidance of both fluoroscopic and IVUS imaging, along with insertion of the IVUS catheter into a vein parallel to the target artery...
August 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28692458/angiographic-and-clinical-outcomes-after-recanalization-of-coronary-chronic-total-occlusions-with-the-orsiro-sirolimus-eluting-stent-compared-with-the-resolute-zotarolimus-eluting-stent
#18
Sinisa Markovic, Michael Lützner, Sergiu Dragomir, Wolfgang Rottbauer, Jochen Wöhrle
OBJECTIVE: The third generation drug eluting Orsiro stent had shown already promising results in non-complex lesions. BACKGROUND: We evaluated angiographic and 24 month clinical results of the sirolimus eluting Orsiro stents (O-SES) after recanalization of coronary chronic total occlusions (CTO). Results were compared with the zotarolimus eluting Resolute Integrity (R-ZES). METHODS: In a prospective series 57 patients were treated with a R-ZES followed by 74 patients treated with a O-SES stent...
August 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28649980/mid-term-outcomes-of-stent-overlap-in-long-total-occluded-lesions-of-superficial-femoral-artery
#19
Ulas Bildirici, Mujdat Aktas, Emir Dervis, Umut Celikyurt
BACKGROUND Superficial femoral artery chronic total occlusion (SCTO) is a common type of peripheral arterial disease (PAD). Endovascular therapy is a treatment approach that has a poor long-term success rate in this group. The aim of this study was to compare the mid-term results of two different uses of nitinol stents in long SCTO lesions (>100 mm): the use of one long stent or two shorter stents. MATERIAL AND METHODS Of 154 patients who underwent percutaneous infrainguinal interventions from 2011 to 2014, a total of 170 CTO lesions were selected for this retrospective study analysis...
June 26, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28616560/successful-revascularization-improves-long-term-clinical-outcome-in-patients-with-chronic-coronary-total-occlusion
#20
Tomohiko Teramoto, Etsuo Tsuchikane, Masanori Yamamoto, Hitoshi Matsuo, Yoshiaki Kawase, Yoriyasu Suzuki, Seiji Kanou, Tetsurou Shimura, Hirotomo Sato, Maoto Habara, Kenya Nasu, Masashi Kimura, Yoshihisa Kinoshita, Mitsuyasu Terashima, Tetsuo Matsubara, Takahiko Suzuki
BACKGROUND: Following the development of breakthrough techniques for percutaneous coronary intervention (PCI) in the treatment of chronic total occlusions (CTO), the initial success rate of PCI in CTO lesions (CTO-PCI) has improved; however, there are few reports regarding the effects of successful CTO revascularization on long-term mortality in Japan. The aim of this study was to compare the long-term clinical outcomes of patients with successful versus failed CTO recanalization and to identify related factors...
March 2017: IJC Heart & Vasculature
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