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CTO LESIONS TREATMENT

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https://www.readbyqxmd.com/read/28616560/successful-revascularization-improves-long-term-clinical-outcome-in-patients-with-chronic-coronary-total-occlusion
#1
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
https://www.readbyqxmd.com/read/28587565/anterolateral-popliteal-puncture-technique-a-novel-retrograde-approach-for-chronic-femoropopliteal-occlusions
#2
Michinao Tan, Kazushi Urasawa, Ryoji Koshida, Takuya Haraguchi, Shunsuke Kitani, Yasumi Igarashi, Katsuhiko Sato
PURPOSE: To describe the feasibility and safety of an anterolateral popliteal puncture technique as a retrograde access to chronic total occlusions (CTOs) in the femoropopliteal segment. METHODS: Twenty consecutive patients (mean age 75.1±10.9 years; 13 women) with symptomatic femoropopliteal occlusive disease underwent endovascular therapy via a retrograde access using the anterolateral popliteal puncture technique. With the patient supine, the P3 segment of the popliteal artery was accessed with a sheathless technique intended to provide minimally invasive access...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28521919/intravascular-ultrasound-analysis-of-intraplaque-versus-subintimal-tracking-in-percutaneous-intervention-for-coronary-chronic-total-occlusions-and-association-with-procedural-outcomes
#3
Lei Song, Akiko Maehara, Matthew T Finn, Sanjog Kalra, Jeffrey W Moses, Manish A Parikh, Ajay J Kirtane, Michael B Collins, Tamim M Nazif, Khady N Fall, Raja Hatem, Ming Liao, Tiffany Kim, Philip Green, Ziad A Ali, Candido Batres, Martin B Leon, Gary S Mintz, Dimitri Karmpaliotis
OBJECTIVES: Using intravascular ultrasound (IVUS), the authors compared outcomes by observed wire position (intraplaque vs. subintimal) achieved during successful chronic total occlusion (CTO) lesion treatment. BACKGROUND: Recent successes in CTO percutaneous coronary intervention (PCI) have used both intraluminal and subintimal wire tracking to improve procedural success. IVUS may be used to determine the course of wire tracking after crossing a CTO. METHODS: From March 2014 to March 2016, data were collected into a single-center database from 219 patients undergoing CTO PCI with concomitant IVUS imaging...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28486842/impact-of-angioscopic-evaluation-for-femoropopliteal-in-stent-restenosis-before-and-after-excimer-laser-atherectomy
#4
Akiko Idemoto, Naotaka Okamoto, Akihiro Tanaka, Naoki Mori, Daisuke Nakamura, Masamichi Yano, Nobuhiko Makino, Yasuyuki Egami, Ryu Shutta, Jun Tanouchi, Masami Nishino
In-stent restenosis (ISR) is a prevalent problem following stenting of femoropopliteal lesions. A potential novel treatment modality for ISR including excimer laser atherectomy (ELA) has become available. We performed ELA for in-stent chronic total occlusion (CTO) of femoropopliteal lesions and evaluated lesion morphology before and after ELA by angioscopy in 2 patients. The angioscopic findings clearly showed removal of in-stent thrombi after ELA. Thus, ELA may be effective for in-stent CTO of femoropopliteal lesions...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28471074/towards-a-contemporary-comprehensive-scoring-system-for-determining-technical-outcomes-of-hybrid-percutaneous-chronic-total-occlusion-treatment-the-recharge-score
#5
Joren Maeremans, James C Spratt, Paul Knaapen, Simon Walsh, Pierfrancesco Agostoni, William Wilson, Alexandre Avran, Benjamin Faurie, Erwan Bressollette, Peter Kayaert, Alan J Bagnall, Dave Smith, Margaret B McEntegart, William H T Smith, Paul Kelly, John Irving, Elliot J Smith, Julian W Strange, Jo Dens
OBJECTIVES: This study sought to create a contemporary scoring tool to predict technical outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) from patients treated by hybrid operators with differing experience levels. BACKGROUND: Current scoring systems need regular updating to cope with the positive evolutions regarding materials, techniques, and outcomes, while at the same time being applicable for a broad range of operators. METHODS: Clinical and angiographic characteristics from 880 CTO-PCIs included in the REgistry of CrossBoss and Hybrid procedures in FrAnce, the NetheRlands, BelGium and UnitEd Kingdom (RECHARGE) were analyzed by using a derivation and validation set (2:1 ratio)...
May 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28425767/chronic-total-coronary-occlusion-treatment-results
#6
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
#7
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
#8
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...
June 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28382804/optical-coherence-tomography-guided-therapy-of-in-stent-restenosis-for-peripheral-arterial-disease
#9
REVIEW
Michael K Lichtenberg, Jeffrey G Carr, Jaafer A Golzar
Approximately 27 million people in Europe and North America currently have peripheral arterial disease (PAD). The endovascular treatment of stenosis or blocked peripheral arteries in PAD include percutaneous transluminal angioplasty with or without a drug coated balloon (DCB), 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 superficial femoral artery (SFA) lesions, and consequently increased their usage...
August 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28373785/chronic-total-coronary-occlusion-recanalization-current-techniques-and-new-devices
#10
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
#11
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...
May 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28218604/everolimus-eluting-bioresorbable-vascular-scaffold-for-treatment-of-complex-chronic-total-occlusions
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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