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CTO LESIONS TREATMENT

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https://www.readbyqxmd.com/read/28218604/everolimus-eluting-bioresorbable-vascular-scaffold-for-treatment-of-complex-chronic-total-occlusions
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/27650935/prevalence-indications-and-management-of-balloon-uncrossable-chronic-total-occlusions-insights-from-a-contemporary-multicenter-us-registry
#15
Judit Karacsonyi, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, John Bahadorani, Anthony Doing, Ziad A Ali, Aris Karatasakis, Barbara A Danek, Bavana V Rangan, Aya J Alame, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: Balloon uncrossable lesions can be challenging to treat, requiring specialized techniques and equipment. METHODS: We examined the prevalence, clinical and angiographic characteristics, management and procedural outcomes of balloon uncrossable lesions in a multicenter chronic total occlusion (CTO) percutaneous coronary intervention (PCI) registry. RESULTS: Between 2012 and 2016, 718 CTO PCIs (in which the occlusion was successfully crossed with a guidewire) were performed in 701 patients at 11 US centers...
September 21, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27609252/impact-of-chronic-total-occlusion-of-the-coronary%C3%A2-artery-on-long-term%C3%A2-prognosis-in-patients-with%C3%A2-ischemic-systolic-heart-failure-insights-from-the-commit-hf-registry
#16
Mateusz Tajstra, Łukasz Pyka, Jarosław Gorol, Damian Pres, Marek Gierlotka, Elżbieta Gadula-Gacek, Anna Kurek, Michał Wasiak, Michał Hawranek, Michał Oskar Zembala, Andrzej Lekston, Lech Poloński, Leszek Bryniarski, Mariusz Gąsior
OBJECTIVES: This study sought to assess the impact of chronic total occlusion (CTO) on long-term prognosis in patients with ischemic cardiomyopathy. BACKGROUND: The presence of concomitant CTO in a nonculprit lesion in acute coronary syndromes is associated with worse prognosis. Coronary artery disease is the main cause of heart failure and in many cases at least 1 CTO is observed. METHODS: The study included all patients with systolic heart failure who underwent elective coronary angiography and were registered from January 2009 to December 2014 in the ongoing single-center COMMIT-HF (COnteMporary Modalities In Treatment of Heart Failure) registry (NCT02536443)...
September 12, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27558463/tibiopedal-access-for-crossing-of-infrainguinal-artery-occlusions-a-prospective-multicenter-observational-study
#17
Craig M Walker, Jihad Mustapha, Thomas Zeller, Andrej Schmidt, Miguel Montero-Baker, Aravinda Nanjundappa, Marco Manzi, Luis Mariano Palena, Nelson Bernardo, Yazan Khatib, Robert Beasley, Luis Leon, Fadi A Saab, Adam R Shields, George L Adams
PURPOSE: To report a prospective, multicenter, observational study (ClinicalTrials.gov identifier NCT01609621) of the safety and effectiveness of tibiopedal access and retrograde crossing in the treatment of infrainguinal chronic total occlusions (CTOs). METHODS: Twelve sites around the world prospectively enrolled 197 patients (mean age 71±11 years, range 41-93; 129 men) from May 2012 to July 2013 who met the inclusion criterion of at least one CTO for which a retrograde crossing procedure was planned or became necessary...
December 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27381939/indications-and-outcomes-of-excimer-laser-coronary-atherectomy-efficacy-and-safety-for-thrombotic-lesions-the-ultraman-registry
#18
Masami Nishino, Naoki Mori, Shin Takiuchi, Daisuke Shishikura, Naofumi Doi, Toru Kataoka, Takayuki Ishihara, Noriyuki Kinoshita
BACKGROUND: Excimer laser coronary atherectomy (ELCA) recently became available in Japan, but ELCA's effectiveness and safety are not clear. METHODS AND RESULTS: We enrolled consecutive patients who underwent ELCA and were registered in the Utility of Laser for Transcatheter Atherectomy-Multicenter Analysis around Naniwa (ULTRAMAN) registry comprising six Japanese medical centers around Naniwa in Japan with patients registered from April 2006 to June 2015. We evaluated the catheter sizes used and compared the success rate, thrombolysis in myocardial infarction (TIMI) flow, blush score, and complications between the rich-thrombus (RT) group [acute coronary syndrome (ACS) and saphenous vein graft (SVG)] and the poor-thrombus (PT) group [in-stent restenosis (ISR), chronic total occlusion (CTO), calcification, and long or bifurcation (L&B) lesions]...
January 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/27290681/rationale-and-design-of-the-syntax-ii-trial-evaluating-the-short-to-long-term-outcomes-of-state-of-the-art-percutaneous-coronary-revascularisation-in-patients-with-de-novo-three-vessel-disease
#19
Javier Escaned, Adrian Banning, Vasim Farooq, Mauro Echavarria-Pinto, Yoshinobu Onuma, Nicola Ryan, Rafael Cavalcante, Carlos M Campos, Bojan M Stanetic, Yuki Ishibashi, Pannipa Suwannasom, Arie-Pieter Kappetein, David Taggart, Marie-Angèle Morel, Gerrit-Anne van Es, Patrick W Serruys
AIMS: The applicability of the results of the SYNTAX trial comparing percutaneous coronary intervention (PCI) using first-generation drug-eluting stents (DES) with coronary artery bypass graft (CABG) surgery for the treatment of patients with complex coronary artery disease (CAD) has been challenged by recent major technical and procedural developments in coronary revascularisation. Functional assessment of coronary lesions has contributed to marked improvements in both safety and efficacy of DES implantation...
June 12, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27188085/-percutaneous-treatment-of-coronary-chronic-total-occlusions
#20
REVIEW
Olli A Kajander, Erkki Ilveskoski, Risto Jussila
Chronic total occlusions (CTOs) are frequently detected on diagnostic coronary angiograms. For the selection of patients for CTO percutaneous coronary intervention, factors such as the level of symptoms, level of myocardial viability and extent of ischemia must be taken into account. Remarkable progress has been achieved in the success of complex CTO procedures during the past decade. In addition to antegrade wire escalation strategy, subintimal passage of the guidewire with or without dissection and re-entry techniques and retrograde techniques can be utilized...
2016: Duodecim; Lääketieteellinen Aikakauskirja
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