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chronic total occlusion pci

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https://www.readbyqxmd.com/read/28325520/percutaneous-revascularization-of-coronary-chronic-total-occlusion-toward-a-reappraisal-of-the-available-evidence
#1
REVIEW
Pasi P Karjalainen, Wail Nammas
Chronic total occlusion (CTO) is a challenging subset of coronary artery disease that is commonly encountered in real-world practice; it is associated with worse long-term prognosis. Observational studies suggest that percutaneous coronary intervention (PCI) for CTO is associated with reduction in myocardial ischemia and improvement in quality of life and left ventricular function. Some observational studies suggested that CTO-PCI is associated with improvement of the 'hard' clinical endpoints; others did not...
March 18, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28318134/long-term-clinical-outcomes-of-successful-revascularization-with-drug-eluting-stents-for-chronic-total-occlusions-a-systematic-review-and-meta-analysis
#2
Lei Gao, Yabin Wang, Yuqi Liu, Feng Cao, Yundai Chen
OBJECTIVES: To determine whether successful percutaneous coronary intervention (PCI) using drug-eluting stents (DESs) have beneficial effects on long-term outcomes in patients with chronic total occlusions (CTOs) compared with failed PCIs for CTOs. BACKGROUND: Several observational studies have evaluated the long-term clinical outcomes of successful PCIs using DESs for CTOs. However, the results of these studies were inconsistent and inconclusive. METHODS: We searched five online electronic databases to identify all the publications assessing the long-term outcomes of successful and failed PCIs using DESs for CTOs...
March 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28316035/management-of-percutaneous-coronary-intervention-complications
#3
REVIEW
Gregory Means, Christopher End, Prashant Kaul
With the recent increase in complex coronary interventions including percutaneous coronary intervention (PCI) for chronic total occlusions and complex higher risk (and indicated) patients, the spectrum of potential periprocedural complications and their prompt management has become even more relevant. Vascular access-related problems remain the most prevalent of all PCI complications and with randomized controlled trial data from over 20,000 patients supporting the superiority of radial over femoral access in reducing bleeding and vascular complications, a default radial strategy should be promoted...
April 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28315181/update-on-the-management-of-chronic-total-occlusions-in-coronary-artery-disease
#4
REVIEW
Kathleen Kearney, Ravi S Hira, Robert F Riley, Arun Kalyanasundaram, William L Lombardi
PURPOSE OF THE REVIEW: Chronic total occlusions (CTOs) are found in about a third of patients with coronary artery disease (CAD) and can pose a significant challenge during percutaneous revascularization. However, advances in CTO percutaneous coronary intervention (PCI) strategies, devices, and algorithms have led to significant improvements in successful treatment of CTOs. This review summarizes current management of CTOs in the context of modern PCI techniques and current evidence. RECENT FINDINGS: The hybrid algorithm now provides a standardized, teachable approach to CTO PCI, and success rates are approximately 90% in experienced hands...
April 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28314674/further-validation-of-the-hybrid-algorithm-for-cto-pci-difficult-lesions-same-success
#5
Mir B Basir, Aris Karatasakis, Mohammad Alqarqaz, Barbara Danek, Bavana V Rangan, Emmanouil S Brilakis, Henry Kim, William W O'Neill, Khaldoon Alaswad
OBJECTIVES: To evaluate the success rates and outcome of the hybrid algorithm for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) by a single operator in two different clinical settings. METHODS: We compared 279 consecutive CTO PCIs performed by a single, high-volume operator using the hybrid algorithm in two different clinical settings. Data were collected through the PROGRESS CTO Registry. We compared 145 interventions performed in a community program (cohort A) with 134 interventions performed in a referral center (cohort B)...
February 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28303648/subadventitial-techniques-for-chronic-total-occlusion-percutaneous-coronary-intervention-the-concept-of-vessel-architecture
#6
Lorenzo Azzalini, Mauro Carlino, Emmanouil S Brilakis, Minh Vo, Stéphane Rinfret, Barry F Uretsky, Dimitri Karmpaliotis, Antonio Colombo
Despite improvements in guidewire technologies, the traditional antegrade wire escalation approach to chronic total occlusion (CTO) recanalization is successful in only 60-80% of selected cases. In particular, long, calcified, and tortuous occlusions are less successfully approached with a true-to-true lumen approach. Frequently, the guidewire tracks into the subadventitial space, with no guarantee of distal re-entry into the true lumen. The ability to manage the subadventitial space has been a key step in the tremendous improvement in success rates of contemporary CTO percutaneous coronary intervention (PCI), whether operating antegradely or retrogradely...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28296045/one-year-outcomes-after-successful-chronic-total-occlusion-percutaneous-coronary-intervention
#7
W M Wilson, S J Walsh, A Bagnall, A T Yan, C G Hanratty, M Egred, E Smith, K G Oldroyd, M McEntegart, J Irving, H Douglas, J Strange, J C Spratt
We aimed to determine clinical outcomes 1 year after successful chronic total occlusion (CTO) PCI and, in particular, whether use of dissection and re-entry strategies affects clinical outcomes. Hybrid approaches have increased the procedural success of CTO percutaneous coronary intervention (PCI) but longer-term outcomes are unknown, particularly in relation to dissection and re-entry techniques. Data were collected for consecutive CTO PCIs performed by hybrid-trained operators from 7 United Kingdom (UK) centres between 2012 and 2014...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28290908/-coronary-angioplasty-and-stenting-in-patients-older-than-80-years-immediate-and-long-term-results
#8
A M Babunashvili, D P Dundua, D S Kartashov, A A Bazarnova, A Yu Korenevich, M E Vetluzhskikh
AIM: to assess immediate and long-term results of coronary angioplasty and stenting in patients older than 80 years - a high risk group in view of the severity of concomitant pathology and extent of coronary atherosclerosis. MATERIAL AND METHODS: We conducted retrospective analysis of data from 167 patients older than 80 years (mean age 81.43+/-2.14 years) subjected to percutaneous coronary intervention from 2006 to 2013 (3.2% from total number of patients). Multivessel involvement was present in 128 patients (76...
July 2016: Kardiologiia
https://www.readbyqxmd.com/read/28274578/comparison-of-ct-rector-and-j-cto-scores-to-predict-chronic-total-occlusion-difficulty-for-percutaneous-coronary-intervention
#9
Yahang Tan, Jia Zhou, Wei Zhang, Ying Zhou, Luoshan Du, Feng Tian, Jun Guo, Lian Chen, Feng Cao, Yundai Chen
BACKGROUND: We sought to evaluate the ability of the CT-RECTOR and J-CTO scores to predict time-efficient guidewire (GW) crossing through a chronic total occlusion (CTO) and final procedure success. METHODS: Data from 191 consecutive CTO lesions with pre-procedural coronary computed tomography angiography (CCTA) from our center were analyzed retrospectively. The difficulty of the procedure was classified as easy, intermediate, difficult, or very difficult according to CT-RECTOR and J-CTO scores...
February 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28268135/-negative-angiographic-markers-in-percutaneous-coronary-intervention-of-chronic-total-occlusions
#10
Mohsen Mohandes, Jordi Guarinos, Judit Rodríguez, Gil Bonet, Francisco Fernández, Sergio Rojas, Cristina Moreno, Ramón de Castro, Jordi Mercé, Alfredo Bardají
OBJECTIVE: The purpose of this study is to identify negative angiographic predictive variables and the presence of a side branch close to the occlusion distal cap in the chronic total occlusion percutaneous coronary intervention outcome. METHODS: Potential negative angiographic variables were retrospectively evaluated in 156 chronic total occlusions undergone a percutaneous coronary intervention. Binary logistic regression with predictive purpose was utilized in order to identify a model of variables which all in all could successfully predict a negative intervention result...
March 3, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28256296/prediction-of-functional-recovery-after-percutaneous-coronary-revascularization-for-chronic-total-occlusion-using-late-gadolinium-enhanced-magnetic-resonance-imaging
#11
Tatsuya Nakachi, Shingo Kato, Hidekuni Kirigaya, Naoki Iinuma, Kazuki Fukui, Naka Saito, Tae Iwasawa, Masami Kosuge, Kazuo Kimura, Kouichi Tamura
BACKGROUND: Limited data are available regarding the prediction for functional recovery using late gadolinium enhanced magnetic resonance imaging (LGE MRI) after coronary revascularization for chronic total occlusion (CTO PCI). METHODS: We studied 59 patients (mean age, 66±11 years) who underwent successful CTO PCI. Two-dimensional echocardiography and strain measurements were performed before and 8±2 months after CTO PCI. The findings of segmental assessment were compared with the extent of LGE MRI using a 16-segment model...
February 27, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28255103/percutaneous-coronary-intervention-of-coronary-chronic-total-occlusions-improves-peak-oxygen-uptake-during-cardiopulmonary-exercise-testing
#12
Shuaib M Abdullah, Jeffrey L Hastings, Suwetha Amsavelu, Fransisco Garcia-Morales, Fury Hendrix, Aris Karatasakis, Barbara A Danek, Judit Karacsonyi, Bavana V Rangan, Michele Roesle, Houman Khalili, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: Although coronary chronic total occlusions (CTOs) are treated with percutaneous coronary intervention (PCI) to improve symptoms, studies demonstrating symptom improvement have been mostly limited to questionnaire responses. The current study assessed for changes in peak oxygen uptake during cardiopulmonary exercise testing after CTO-PCI. METHODS: Patients with heart failure or angina symptoms referred for CTO-PCI were prospectively enrolled. The primary outcome of the study was improvement in peak oxygen uptake during cardiopulmonary exercise (CPX) testing 5 months after CTO-PCI...
March 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28244014/gender-based-acute-outcome-in-percutaneous-coronary-intervention%C3%A2-of-chronic-total-coronary-occlusion
#13
J E Guelker, L Bansemir, R Ott, K Kuhr, B Koektuerk, R G Turan, H G Klues, A Bufe
BACKGROUND: Percutaneous coronary intervention (PCI) of total chronic coronary occlusion (CTO) still remains a major challenge. Insignificant data are reported in the literature about gender differences in CTO-PCI in the era of new drug-eluting stents. In this study we analysed the impact of gender on procedural characteristics, complications and acute results. METHODS: Between 2010-2015 we included 780 consecutive patients. They underwent PCI for at least one CTO...
February 27, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28242588/effects-of-successful-percutaneous-coronary-intervention-of-chronic-total-occlusions-on-myocardial-perfusion-and-left-ventricular-function
#14
Wijnand J Stuijfzand, P Stefan Biesbroek, Pieter G Raijmakers, Roel S Driessen, Stefan P Schumacher, Pepijn van Diemen, Jeffrey van den Berg, Robin Nijveldt, Adriaan A Lammertsma, Simon J Walsh, Colm G Hanratty, James C Spratt, Albert C van Rossum, Alexander Nap, Niels van Royen, Paul Knaapen
AIMS: The aim of the present study was to investigate the effects of successful PCI CTO on absolute myocardial blood flow (MBF) and functional recovery. METHODS AND RESULTS: Patients with a documented CTO were prospectively examined for ischemia and viability with H215O positron emission tomography (PET) and late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMR). Sixty-nine consecutive patients, in whom PCI was successful, underwent follow-up PET and CMR after approximately 12 weeks to evaluate potential improvement of MBF as well as systolic function...
February 28, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28242587/impact-of-crossing-strategy-on-mid-term-outcomes-following-percutaneous-revascularisation-of-coronary-chronic-total-occlusions
#15
Lorenzo Azzalini, Rustem Dautov, Emmanouil S Brilakis, Soledad Ojeda, Susanna Benincasa, Barbara Bellini, Aris Karatasakis, Jorge Chavarría, Bavana V Rangan, Manuel Pan, Mauro Carlino, Antonio Colombo, Stéphane Rinfret
AIMS: To compare the impact of crossing strategies on mid-term outcomes following chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS AND RESULTS: We compiled a multicentre registry of consecutive patients undergoing successful CTO PCI. Patients were divided in three groups: true-to-true (TTT) approach, modern dissection/re-entry (DR) techniques (CrossBoss/Stingray, reverse CART), and old DR techniques (LAST, STAR, CART). Cox regression was used to identify independent predictors of major adverse cardiac events (MACE: cardiac death, myocardial infarction and target-vessel revascularisation)...
February 28, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28242583/clinical-implications-of-the-residual-syntax-score-after-percutaneous-coronary-intervention-in-patients-with-chronic-total-occlusion-and-multi-vessel-coronary-artery-disease-a-comparison-with-coronary-artery-bypass-grafting
#16
Woo Jin Jang, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Woo Jung Chun, Ju Hyeon Oh, Yong Hwan Park, Wook Sung Kim, Young Tak Lee, Hyeon-Cheol Gwon, Seung-Hyuk Choi
AIMS: We evaluated clinical impact of residual SYNTAX score (rSS) after percutaneous coronary intervention (PCI) in patients with chronic total occlusion (CTO) and multi-vessel coronary artery disease (CAD). METHODS AND RESULTS: We analyzed data from 1,043 patients with CTO and multi-vessel CAD who were treated with PCI or coronary artery bypass grafting (CABG). Patients were divided into three groups: patients with rSS≤12 after PCI (rSS≤12 group, n=445), patients with rSS>12 after PCI (rSS>12 group, n=150), and patients who underwent CABG (CABG group, n=448)...
February 28, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28236020/impact-of-multi-vessel-versus-single-vessel-disease-on-outcomes-after-percutaneous-coronary-interventions-for-chronic-total-occlusions
#17
Aurel Toma, Barbara E Stähli, Michael Gick, Cathérine Gebhard, Thomas Nührenberg, Kambis Mashayekhi, Miroslaw Ferenc, Franz-Josef Neumann, Heinz Joachim Buettner
BACKGROUND: Successful chronic total occlusion (CTO) revascularization has been associated with prognostic benefits. Whether the extent of coronary artery disease interferes with these benefits has not been investigated yet. AIMS: We sought to compare the survival after percutaneous coronary intervention (PCI) for CTO between patients with multi- (MVD) and single-vessel disease (SVD). METHODS: A total of 2002 consecutive patients undergoing CTO PCI between 01/2005 and 12/2013 were identified and stratified according to the presence/absence of MVD...
February 24, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28218604/everolimus-eluting-bioresorbable-vascular-scaffold-for-treatment-of-complex-chronic-total-occlusions
#18
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/28214141/feasibility-and-safety-of-same-day-discharge-after-complex-percutaneous-coronary-intervention-using-forearm-approach
#19
Michael Koutouzis, Aris Karatasakis, Emmanouil S Brilakis, Maria Agelaki, Christos Maniotis, Panagiotis Dimitriou, Efstathios Lazaris
OBJECTIVES: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach. BACKGROUND: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study. METHODS: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital...
February 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28197870/intravascular-ultrasound-guidance-of-percutaneous-coronary-intervention-in-ostial-chronic-total-occlusions-a-description-of-the-technique-and-procedural-results
#20
Nicola Ryan, Nieves Gonzalo, Philip Dingli, Oscar Vedia Cruz, Pilar Jiménez-Quevedo, Luis Nombela-Franco, Ivan Nuñez-Gil, María Del Trigo, Pablo Salinas, Carlos Macaya, Antonio Fernandez-Ortiz, Javier Escaned
Inability to cross the lesion with a guidewire is the most common reason for failure in percutaneous revascularization (PCI) of chronic total occlusions (CTOs). An ostial or stumpless CTO is an acknowledged challenge for CTO recanalization due to difficulty in successful wiring. IVUS imaging provides the opportunity to visualize the occluded vessel and to aid guidewire advancement. We review the value of this technique in a single-centre experience of CTO PCI. This series involves 22 patients who underwent CTO-PCI using IVUS guidance for stumpless CTO wiring at our institution...
February 14, 2017: International Journal of Cardiovascular Imaging
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