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CTO LESIONS TREATMENT

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https://www.readbyqxmd.com/read/28425767/chronic-total-coronary-occlusion-treatment-results
#1
Martin Kirk Christensen, Phillip Fischer Freeman, Jeppe Groendal Rasmussen, Anton Boel Villadsen, Bent Raungaard, Svend Eggert Jensen, Leif Thuesen
OBJECTIVES: To describe the clinical and procedural coronary chronic total occlusion (CTO) treatment results in a Nordic PCI centre during the implementation of a CTO treatment program. DESIGN: In a retrospective registry study, we assessed; (1) indication for the procedure, (2) Canadian Cardiovascular Society angina pectoris score (CCS)/New York Heart Association (NYHA) heart failure score, (3) lesion complexity and (4) adverse events during hospital stay and three months following the index procedure...
April 20, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28419791/the-role-of-rotational-atherectomy-in-contemporary-chronic-total-occlusion-percutaneous-coronary-intervention
#2
EDITORIAL
Yader Sandoval, Emmanouil S Brilakis
Rotational atherectomy is performed infrequently (∼3.5%) during chronic total occlusion (CTO) percutaneous coronary intervention (PCI) for two indications: treatment of balloon uncrossable and balloon undilatable lesions. Use of rotational atherectomy in CTO PCI was associated with high success and acceptable complication rates. Rotational atherectomy remains a "must have" device for interventional cardiologists performing complex PCI.
April 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28393673/lower-extremity-revascularization-using-optical-coherence-tomography-guided-directional-atherectomy-final-results-of-the-evaluation-of-the-pantheris-optical-coherence-tomography-imaging-atherectomy-system-for-use-in-the-peripheral-vasculature-vision-study
#3
Arne G Schwindt, J Gray Bennett, William H Crowder, Suhail Dohad, Sean F Janzer, Jon C George, Barry Tedder, Thomas P Davis, Ian M Cawich, Roger S Gammon, Patrick E Muck, John P Pigott, Dwight A Dishmon, Lou A Lopez, Jaafer A Golzar, Jack R Chamberlin, Michael J Moulton, Ramzan M Zakir, Amir K Kaki, Gary J Fishbein, Huey B McDaniel, Ayala Hezi-Yamit, John B Simpson, Arjun Desai
PURPOSE: To evaluate the safety and efficacy of a novel optical coherence tomography (OCT)-guided atherectomy catheter in treating patients with symptomatic femoropopliteal disease. METHODS: The VISION trial ( ClinicalTrials.gov identifier NCT01937351) was a single-arm, multicenter, global investigational device exemption study enrolling 158 subjects (mean age 67.2±10.5 years; 87 men) across 20 participating sites. In this cohort, 198 lesions were treated with an average length of 53±40 mm using the Pantheris catheter alone or Pantheris + adjunctive therapy...
April 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28382804/optical-coherence-tomography-guided-therapy-of-instent-restenosis-for-peripheral-arterial-disease
#4
Michael K Lichtenberg, Jeffrey G Carr, Jaafer A Golzar
Approximately 27 million people in Europe and North America currently have peripheral arterial disease (PAD)1. The endovascular treatment of stenosis or blocked peripheral arteries in PAD include percutaneous transluminal angioplasty (PTA) with or without a drug coated balloon, atherectomy (rotational, directional, orbital or laser), and stenting. The development of next generation peripheral stents and drug coated stents have led to the improved treatment of complex SFA lesions, and consequently increased their usage23...
April 4, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28373785/chronic-total-coronary-occlusion-recanalization-current-techniques-and-new-devices
#5
REVIEW
Jan-Erik Gülker, Lars Bansemir, Heinrich G Klues, Alexander Bufe
Percutaneous coronary intervention (PCI) of total chronic coronary occlusion (CTO) still remains a major challenge. The prevalence of a CTO has been reported to be up to 30% among patients with a clinical indication for coronary angiography. Progress has been made with further advanced interventional techniques and continuously sophisticated interventional tools. Nevertheless the number of interventions carried out to recanalize a CTO is less than 10% of all procedures. Benefits of a successful CTO recanalization include relief of angina pectoris and ischemia-related dyspnea, substantial improvement in left ventricular function and, avoidance of surgery treatment...
April 2017: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/28238927/initial-and-long-term-results-of-a-microcatheter-based-retrograde-approach-for-the-endovascular-treatment-of-chronic-total-occlusion-in-iliac-or-femoropopliteal-arteries
#6
Junya Matsumi, Takuma Takada, Noriaki Moriyama, Tomoki Ochiai, Kazuki Tobita, Koki Shishido, Kazuya Sugitatsu, Shingo Mizuno, Futoshi Yamanaka, Masato Murakami, Yutaka Tanaka, Saeko Takahashi, Takeshi Akasaka, Shigeru Saito
BACKGROUND: Initial and long-term outcomes of the retrograde endovascular approach using a microcatheter for the treatment of chronic total occlusion (CTO) in the iliac or femoropopliteal (FP) arteries have not been fully elucidated. METHODS: From 2012 to 2014, 20 consecutive patients (21 limbs) underwent endovascular therapy (EVT) for CTO in the iliac or FP arteries using the microcatheter-based retrograde approach. An analysis of the initial and long-term outcomes was conducted...
February 24, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28218604/everolimus-eluting-bioresorbable-vascular-scaffold-for-treatment-of-complex-chronic-total-occlusions
#7
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/28216476/combined-use-of-directional-atherectomy-and-drug-coated-balloon-for-the-endovascular-treatment-of-common-femoral-artery-disease-immediate-and-one-year-outcomes
#8
Angelo Cioppa, Eugenio Stabile, Luigi Salemme, Grigore Popusoi, Armando Pucciarelli, Fortunato Iacovelli, Antonella Arcari, Enrico Coscioni, Bruno Trimarco, Giovanni Esposito, Tullio Tesorio
AIMS: Surgical endarterectomy is the therapy of choice for atherosclerotic common femoral artery (CFA) obstruction. Recently, some large single-centre series have shown encouraging results for the percutaneous treatment of CFA obstructions. The purpose of this study was to evaluate the safety, feasibility, and one-year efficacy of the endovascular treatment of CFA obstructions with combined use of directional atherectomy (DA) and a paclitaxel-coated balloon (DCB). METHODS AND RESULTS: Between January 2012 and July 2014, 30 consecutive patients with severely calcified obstructions of the common femoral artery were treated in our centre using DA followed by DCB dilatation...
February 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28104206/randomized-multicenter-trial-investigating%C3%A2-angiographic-outcomes-of%C3%A2-hybrid-sirolimus-eluting-stents-with%C3%A2-biodegradable-polymer-compared-with%C3%A2-everolimus-eluting-stents-with-durable%C3%A2-polymer-in-chronic-total-occlusions-the-prison-iv-trial
#9
Koen Teeuwen, René J van der Schaaf, Tom Adriaenssens, Jacques J Koolen, Pieter C Smits, José P S Henriques, Paul H M J Vermeersch, R Melvyn Tjon Joe Gin, Bastiaan E Schölzel, Johannes C Kelder, Jan G P Tijssen, Pierfrancesco Agostoni, Maarten J Suttorp
OBJECTIVES: The aim of this study was to investigate the efficacy and safety of the hybrid ultrathin-strut sirolimus-eluting stent (SES) with biodegradable polymer compared with the thin-strut everolimus-eluting stent (EES) with durable polymer in successfully recanalized chronic total occlusions (CTOs). BACKGROUND: The introduction of drug-eluting stents revolutionized the treatment of CTOs. However, limited data are available on new-generation drug-eluting stents with biodegradable polymer in CTOs...
January 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28069611/bioresorbable-vascular-scaffolds-for-the-treatment-of-chronic-total-occlusions-an-international-multicenter-registry
#10
Satoru Mitomo, Toru Naganuma, Yusuke Fujino, Hiroyoshi Kawamoto, Sandeep Basavarajaiah, Michael Pitt, Wei-Hsian Yin, Damras Tresukosol, Antonio Colombo, Sunao Nakamura
BACKGROUND: There are only limited studies reporting clinical outcomes after bioresorbable vascular scaffold (BVS; Absorb; Abbott Vascular, Santa Clara, CA) implantation for coronary chronic total occlusions (CTO). The aim of this study was to evaluate the real-world feasibility and safety of BVS implantation for the treatment of CTO. METHODS AND RESULTS: We retrospectively evaluated CTO cases treated with BVS from a multicenter registry. The primary end point was target lesion failure defined as a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization...
January 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28045410/clinical-and-angiographic-outcomes-at-more-than-1-year-after-treatment-of-chronic-total-occlusions-with-the-everolimus-eluting-bioresorbable-vascular-scaffold
#11
Aylin Hatice Yamaç, Abdülkadir Yıldız, Meherrem Nasifov, Ahmet Taştan, Nemat Bashirov, Ömer Göktekin
OBJECTIVE: Treatment of chronic total occlusion (CTO) with everolimus-eluting bioresorbable vascular scaffold (BVS) is safe and effective at short-term follow-up (FU). The current study investigated clinical and angiographic outcomes after treatment of CTO with BVS at >1 year. METHODS: Thirty patients who underwent successful recanalization of 35 CTOs were included in this study. Quantitative coronary angiography (QCA) was performed at median FU period of 402 days...
December 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28041711/bifurcation-lesions-involved-in-the-recanalization-process-of-coronary-chronic-total-occlusions-incidence-treatment-and-clinical-implications
#12
Soledad Ojeda, Manuel Pan, Alejandro Gutiérrez, Miguel Romero, Jorge Chavarría, Javier Suárez de Lezo, Francisco Mazuelos, Laura Pardo, Francisco Hidalgo, Francisco Carrasco, José Segura, Enrique Durán, Carlos Ferreiro, José J Sánchez, Sara Rodríguez, Jesús Oneto, Jose Suárez de Lezo
BACKGROUND: The presence of a bifurcation (BL) in the context of a coronary chronic total occlusion (CTO) represents an additional difficulty. This study analyzes the incidence of BLs in CTO recanalization, the treatment, predictors of bifurcation technical success and their clinical impact. METHODS AND RESULTS: BLs with a side branch (SB) ≥2.0mm located proximally, distally or within the occluded segment were observed in 130 (33%) of 391 CTO. Provisional stenting was the strategy more frequently used (94%)...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27993757/percutaneous-intervention-in-chronic-total-coronary-occlusions-caused-by-in-stent-restenosis-procedural-results-and-long-term-clinical-outcomes-in-the-toro-spanish-registry-of-chronic-total-occlusion-secondary-to-an-occlusive-in-stent-restenosis-multicenter
#13
José M de la Torre Hernandez, José R Rumoroso, Asier Subinas, Nieves Gonzalo, Soledad Ojeda, Manuel Pan, Victoria Martín Yuste, Alfonso Suárez, Felipe Hernández, Luis Teruel, José Moreu, José M Cubero, José D Cascón, Hugo Vinhas, Íñigo Lozano, Javier Martin Moreiras, Armando Pérez de Prado, Javier Goicolea, Javier Escaned
AIMS: Limited data exist on the treatment and outcomes of patients with chronic total occlusions due to in-stent restenosis (CTO-ISR). We sought to evaluate results and clinical outcomes in percutaneous interventions over CTO-ISR. METHODS AND RESULTS: Registry in 16 centers involving consecutive patients undergoing attempt of percutaneous intervention over CTO-ISR. A total of 233 patients were included, 192 (82.4%) with successful acute result. Success rate was significantly lower in patients with: lesion in circumflex artery, ostial lesion, J score > 3 and no femoral access...
December 20, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27845998/bioresorbable-scaffolds-compared-with-everolimus-eluting-stents-for-the-treatment-of-chronic-coronary-total-occlusion-clinical-and-angiographic-results-of-a-matched-paired-comparison
#14
Christine Kugler, Sinisa Markovic, Wolfgang Rottbauer, Jochen Wöhrle
OBJECTIVES: Data on bioresorbable vascular scaffolds for recanalization of chronic total occlusions (CTOs) are limited. We compared the bioresorbable scaffold Absorb with everolimus-eluting stents for the treatment of true CTO. METHODS: After recanalization of CTO, 15 lesions treated with the bioresorbable scaffold Absorb were matched with 15 lesions receiving everolimus-eluting stent (EES) (http://www.clinicaltrials.gov NCT02162082). Match criteria were presence of diabetes mellitus, total device length and maximal device diameter...
March 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/27832850/comparative-assessment-of-procedure-cost-and-outcomes-between-guidewire-and-crossing-device-strategies-to-cross-peripheral-artery-chronic-total-occlusions
#15
Subhash Banerjee, Haekyung Jeon-Slaughter, Shirling Tsai, Atif Mohammad, Mazin Foteh, Mazen Abu-Fadel, Osvaldo S Gigliotti, Ian Cawich, Gerardo Rodriguez, Dharam Kumbhani, Tayo Addo, Michael Luna, Tony S Das, Anand Prasad, Ehrin J Armstrong, Nicolas W Shammas, Emmanouil S Brilakis
OBJECTIVES: The aim of this study was to assess actual procedural costs and outcomes comparing wire-catheter and dedicated chronic total occlusion (CTO) device strategies to cross peripheral artery CTOs. BACKGROUND: Peripheral artery CTO interventions are frequently performed, but there are limited data on actual procedural costs and outcomes comparing wire-catheter and dedicated CTO devices. METHODS: The XLPAD (Excellence in Peripheral Artery Disease Intervention) registry (NCT01904851) was accessed to retrospectively compare cost and 30-day and 12-month outcomes of wire-catheter and crossing device strategies for treatment of infrainguinal peripheral artery CTO...
November 14, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27832848/determinants-and-prognostic-significance-of-periprocedural-myocardial-injury-in-patients-with-successful-percutaneous-chronic-total-occlusion-interventions
#16
Seung-Whan Lee, Pil H Lee, Se H Kang, Hanul Choi, Mineok Chang, Jae-Hyung Roh, Sung-Han Yoon, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
OBJECTIVES: This study sought to evaluate the determinants and prognostic implications of periprocedural myocardial injury (PMI) in successful percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs). BACKGROUND: There are limited studies addressing the risk factors and clinical implication of PMI in patients undergoing CTO-PCI. METHODS: We examined 1,058 consecutive CTO patients who underwent successful drug-eluting stent implantation and serial measurements of creatine kinase-myocardial band (CK-MB) values between March 2003 and August 2014...
November 14, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27765802/procedural-and-long-term-outcomes-of-bioresorbable-scaffolds-versus-drug-eluting-stents-in-chronic-total-occlusions-the-bonito-registry-bioresorbable-scaffolds-versus-drug-eluting-stents-in-chronic-total-occlusions
#17
Lorenzo Azzalini, Gennaro Giustino, Soledad Ojeda, Antonio Serra, Alessio La Manna, Hung Q Ly, Barbara Bellini, Susanna Benincasa, Jorge Chavarría, Livia L Gheorghe, Giovanni Longo, Eligio Miccichè, Guido D'Agosta, Fabien Picard, Manuel Pan, Corrado Tamburino, Azeem Latib, Mauro Carlino, Alaide Chieffo, Antonio Colombo
BACKGROUND: There is little evidence regarding the efficacy and safety of bioresorbable scaffolds (BRS) for the percutaneous treatment of chronic total occlusions. METHODS AND RESULTS: We performed a multicenter registry of consecutive chronic total occlusion patients treated with BRS (Absorb; Abbott Vascular) and second-generation drug-eluting stents (DES) at 5 institutions. Long-term target-vessel failure (a composite of cardiac death, target-vessel myocardial infarction, and ischemia-driven target-lesion revascularization) was the primary end point...
October 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27755015/the-outcomes-patient-health-status-and-efficiency-in-chronic-total-occlusion-hybrid-procedures-registry-rationale-and-design
#18
James Sapontis, Steven P Marso, David J Cohen, William Lombardi, Dimitri Karmpaliotis, Jeffrey Moses, William J Nicholson, Ashish Pershad, R Michael Wyman, Anthony Spaedy, Stephen Cook, Parag Doshi, Robert Federici, Craig R Thompson, Karen Nugent, Kensey Gosch, John A Spertus, J Aaron Grantham
BACKGROUND: Patients with chronic total occlusions of a coronary artery represent a complex, yet common, clinical conundrum among patients with ischemic heart disease. Chronic total occlusion angioplasty is increasingly being used as a treatment for these complex lesions. There is a compelling need to better quantify the safety, efficacy, benefits, and costs of the procedure. METHODS: To address these gaps in knowledge, we designed the Outcomes, Patient Health Status, and Efficiency IN Chronic Total Occlusion Hybrid Procedures (OPEN CTO) study, an investigator-initiated multicenter, single-arm registry including 12 centers with a planned enrollment of 1000 patients...
March 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/27749568/initial-clinical-experience-of-crossboss-catheter-for-in-stent-chronic-total-occlusion-lesions-a-case-report
#19
Lei Zhao, Long-Bo Li, Zhi-Hui Wang, Yong-Feng Shi, Jun-Duo Wu, Ji-Chang Zhang, Bin Liu
BACKGROUND: The CrossBoss coronary chronic total occlusion (CTO) crossing catheter has been demonstrated to have greatly improved the success rate of crossing CTO lesions, but there are no published data on its application for in-stent CTO lesions. METHODS: In the current study, we retrospectively reviewed the clinical data of 8 patients with in-stent CTO lesions that were managed with the CrossBoss catheter and herein we report the efficacy and safety of the CrossBoss crossing and re-entry system for this clinically challenging condition...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27665852/five-year-outcomes-of-chronic-total-occlusion-treatment-with-a-biolimus-a9-eluting-biodegradable-polymer-stent-versus-a-sirolimus-eluting-permanent-polymer-stent-in-the-leaders-all-comers-trial
#20
RANDOMIZED CONTROLLED TRIAL
Matteo Ghione, Joanna J Wykrzykowska, Stephan Windecker, Patrick W Serruys, Pawel Buszman, Axel Linke, Hae Young Sohn, Roberto Corti, Diethmar Antoni, William Wijns, Rodrigo Estevez-Loureiro, Marie-Claude Morice, Gerrit-Anne Van Es, Robert Jan van Geuns, Peter Juni, Pedro Eerdmans, Ton De Vries, Stéphanie Konik, Carlo Di Mario
BACKGROUND: Few data are available on long-term follow-up of drug-eluting stents in the treatment of chronic total occlusion (CTO). The LEADERS CTO sub-study compared the long-term results in CTO and non-CTO lesions of a Biolimus A9™-eluting stent (BES) with a sirolimus-eluting stent (SES). METHODS: Among 1,707 patients enrolled in the prospective, multi-center, all-comers LEADERS trial, 81 with CTOs were treated with either a BES (n = 45) or a SES (n = 36). The primary endpoint was the occurrence of major adverse cardiac events (MACE): cardiac death, myocardial infarction (MI) and clinically-indicated target vessel revascularization (TVR)...
2016: Cardiology Journal
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