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CTO LESIONS TREATMENT

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https://www.readbyqxmd.com/read/29747322/-safety-and-efficacy-of-rotational-atherectomy-in-the-interventional-treatment-of-coronary-chronic-total-occlusion-lesions
#1
J Y Ma, J J Guo, L Hou, F Zhang, K Yao, D Huang, H Lu, Y X Dai, C G Li, S F Chang, Q Qin, L Ge, J Y Qian, J B Ge
Objective: To investigate the safety and efficacy of rotational atherectomy in the interventional treatment of coronary chronic total occlusion lesions. Methods: In this retrospective study,a total of 31 consecutive patients with coronary chronic total occlusion(CTO) lesions underwent rotational atherectomy in our hospital from February 2004 to December 2016 were enrolled,and the clinical features were analyzed. Coronary atherectomy was performed if balloon failed to cross the CTO lesions or balloon could not be fully dilated in the CTO lesions after wire crossing...
April 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29741489/initial-result-of-angioscopy-guided-wire-crossing-technique-under-continuous-saline-infusion-for-chronic-total-occlusion-in-femoropopliteal-disease
#2
Masamichi Yano, Keisuke Yasumura, Koji Yasumoto, Akihiro Tanaka, Naoki Mori, Daisuke Nakamura, Yasuyuki Egami, Ryu Shutta, Jun Tanouchi, Masami Nishino
AIMS: We occasionally experience endovascular therapy (EVT) failure as a consequence of wire-crossing into the subintima for chronic total occlusion (CTO) in peripheral arteries. Although several reports have demonstrated the importance of accurate wire-crossing into the ostial site of the CTO true lumen to succeed, it is difficult to visualize the CTO ostium before wiring using angiography or intravascular ultrasonography (IVUS). Thus, we directly visualize the ostial sites of lesions and wire manipulation during EVT by angioscopy and evaluate the efficacy and safety of angioscopy-guided EVT under continuous infusion of saline (AGECIS) in peripheral arteries...
May 8, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29724974/comparison-of-the-transradial-and-transfemoral-approach-in-treatment-of-chronic-total-occlusions-with-similar-lesion-characteristics
#3
Mustafa Ahmet Huyut, Aylin Hatice Yamaç
OBJECTIVE: There is limited data on the efficacy and the safety of the transradial approach (TRA) for percutaneous coronary intervention (PCI) of chronic total occlusion (CTO), particularly in comparison with the transfemoral approach (TFA) in lesions with similar complexity. METHODS: We included 358 patients, who underwent elective CTO PCI between January 2012 and August 2017 and compared the radial (179 patients) and femoral (179 patients) approaches. The J-CTO score was similar in both groups (TRA, 2...
May 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29722796/a-randomized-multicentre-trial-to-compare-revascularization-with-optimal-medical-therapy-for-the-treatment-of-chronic-total-coronary-occlusions
#4
Gerald S Werner, Victoria Martin-Yuste, David Hildick-Smith, Nicolas Boudou, Georgios Sianos, Valery Gelev, Jose Ramon Rumoroso, Andrejs Erglis, Evald Høj Christiansen, Javier Escaned, Carlo di Mario, Thomas Hovasse, Luis Teruel, Alexander Bufe, Bernward Lauer, Kris Bogaerts, Javier Goicolea, James C Spratt, Anthony H Gershlick, Alfredo R Galassi, Yves Louvard
Aims: The clinical value of percutaneous coronary intervention (PCI) for chronic coronary total occlusions (CTOs) is not established by randomized trials. This study should compare the benefit of PCI vs. optimal medical therapy (OMT) on the health status in patients with at least one CTO. Method and results: Three hundred and ninety-six patients were enrolled in a prospective randomized, multicentre, open-label, and controlled clinical trial to compare the treatment by PCI with OMT with a 2:1 randomization ratio...
May 2, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29521465/long-term-outcomes-after-re-entry-device-use-for-recanalization-of-common-iliac-artery-chronic-total-occlusions
#5
Damianos G Kokkinidis, Bejan Alvandi, Ryan Cotter, Prio Hossain, T Raymond Foley, Gagan D Singh, Stephen W Waldo, John R Laird, Ehrin J Armstrong
OBJECTIVE: To examine the impact of re-entry device (RED) use on 1- and 5-year outcomes after endovascular treatment of common iliac artery (CIA) chronic total Occlusions (CTOs). BACKGROUND: There are not enough data regarding the long-term safety and efficacy of RED. METHODS: We performed a two-center retrospective study of 115 patients (140 lesions) undergoing CIA CTO endovascular intervention between 2006 and 2016. Baseline characteristics and long-term outcomes were described...
March 9, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29451512/-antegrade-and-retrograde-approach-through-the-venous-graft-for-treating-a-chronic-total-occlusion-in-a-patient-with-acute-coronary-syndrome-complicated-by-pulmonary-edema
#6
Francesco Gallo, Matteo Tebaldi, Carlo Tumscitz
Percutaneous treatment of chronic total occlusions (CTO) is one of the major challenges in contemporary interventional cardiology. These lesions are identified in 15% to 30% of all patients referred for coronary angiography. Percutaneous coronary intervention (PCI) of CTOs is technically challenging and requires familiarity with advanced interventional techniques as well as specialty equipment. The choice of strategy and materials is based on clinical features and coronary anatomy; the correct choice is essential to improve the success probability...
January 2018: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29411523/first-report-of-the-use-of-long-tapered-sirolimus-eluting-coronary-stent-for-the-treatment-of-chronic-total-occlusions-with-the-hybrid-algorithm
#7
Carlo Zivelonghi, Jan P van Kuijk, Vincent Nijenhuis, Enrico Poletti, Maarten J Suttorp, Jan A S van der Heyden, Frank D Eefting, Benno J Rensing, Jurrien M Ten Berg, Lorenzo Azzalini, Floris S van den Brink, Flavio Ribichini, Antonio Colombo, José P S Henriques, Pierfrancesco Agostoni
BACKGROUND: Coronary chronic total occlusions (CTO) usually coexist with diffusely diseased coronary segments proximal and/or distal to the CTO segment. During percutaneous treatment of CTO, multiple overlapping stents are often needed to treat these long lesions. OBJECTIVES: Aim of this study is to report the first use of long, tapered coronary sirolimus-eluting stents (SES) in this setting. METHODS AND RESULTS: This is a retrospective analysis of 100 consecutive patients undergoing CTO recanalization following the hybrid algorithm...
February 7, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29359452/prevalence-presentation-and-treatment-of-balloon-undilatable-chronic-total-occlusions-insights-from-a-multicenter-us-registry
#8
EDITORIAL
Peter Tajti, Dimitri Karmpaliotis, Khaldoon Alaswad, Catalin Toma, James W Choi, Farouc A Jaffer, Anthony H Doing, Mitul Patel, Ehtisham Mahmud, Barry Uretsky, Aris Karatasakis, Judit Karacsonyi, Barbara A Danek, Bavana V Rangan, Subhash Banerjee, Imre Ungi, Emmanouil S Brilakis
BACKGROUND: The prevalence, treatment and outcomes of balloon undilatable chronic total occlusions (CTOs) have received limited study. METHODS: We examined the prevalence, clinical and angiographic characteristics, and procedural outcomes of percutaneous coronary interventions (PCIs) for balloon undilatable CTOs in a contemporary multicenter US registry. RESULTS: Between 2012 and 2017 data on balloon undilatable lesions were available for 425 consecutive CTO PCIs in 415 patients in whom guidewire crossing was successful: 52 of 425 CTOs were balloon undilatable (12%)...
March 1, 2018: Catheterization and Cardiovascular Interventions
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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...
February 15, 2018: 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
#16
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
#17
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...
February 2018: 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
#18
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
#19
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...
January 1, 2018: 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
#20
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
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