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chronic total occlusion pci

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https://www.readbyqxmd.com/read/28105600/approach-to-cto-intervention-overview-of-techniques
#1
REVIEW
Aris Karatasakis, Barbara Anna Danek, Dimitri Karmpaliotis, Khaldoon Alaswad, Minh Vo, Mauro Carlino, Mitul P Patel, Stéphane Rinfret, Emmanouil S Brilakis
Successful percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) has been associated with significant clinical benefits, but remains technically demanding. Failure to cross the CTO with a guidewire is the most common cause of CTO PCI failure. CTO crossing can be achieved in the antegrade or retrograde direction and can be accomplished by maintaining true lumen position throughout or via subintimal dissection/reentry techniques. A procedural plan should be created prior to the procedure through careful angiographic review of four key parameters: (a) morphology of the proximal occlusion cap; (b) length of the occlusion; (c) quality of the distal vessel and presence of bifurcation at the distal cap; and (d) suitability of collateral circulation for retrograde crossing...
January 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28100874/efficacy-of-multidetector-computed-tomography-to-predict-periprocedural-myocardial-injury-after-percutaneous-coronary-intervention-for-chronic-total-occlusion
#2
Eisuke Usui, Tetsumin Lee, Tadashi Murai, Yoshihisa Kanaji, Junji Matsuda, Makoto Araki, Taishi Yonetsu, Yosuke Yamakami, Shigeki Kimura, Tsunekazu Kakuta
Specific signatures of culprit lesions detected on multidetector computed tomography (MDCT) were identified as predictors of periprocedural myocardial injury (PMI) after percutaneous coronary intervention (PCI) in patients with stable angina; PMI has been shown to be associated with a worse prognosis. We investigated the association between preprocedural culprit lesion characteristics, assessed by MDCT, and PMI after PCI for chronic total occlusion (CTO). From three medical centers, 81 patients who underwent pre-PCI MDCT and CTO PCI, and systematic cardiac troponin (cTn) sampling before and after PCI, were included...
January 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28091872/impact-of-revascularization-of-coronary-chronic-total-occlusion-on-left-ventricular-function-and-electrical-stability-analysis-by-speckle-tracking-echocardiography-and-signal-averaged-electrocardiogram
#3
Yohei Sotomi, Atsunori Okamura, Katsuomi Iwakura, Motoo Date, Hiroyuki Nagai, Tomohiro Yamasaki, Yasushi Koyama, Koichi Inoue, Yasushi Sakata, Kenshi Fujii
The present study aimed to assess the mechanisms of effects of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) from two different aspects: left ventricular (LV) systolic function assessed by two-dimensional speckle tracking echocardiography (2D-STE) and electrical stability evaluated by late potential on signal-averaged electrocardiogram (SAECG). We conducted a prospective observational study with consecutive CTO-PCI patients. 2D-STE and SAECG were performed before PCI, and after 1-day and 3-months of procedure...
January 13, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28089997/the-impact-of-age-and-sex-on-in-hospital-outcomes-of-chronic-total-occlusion-percutaneous-coronary-intervention
#4
Aris Karatasakis, Rahel Iwnetu, Barbara A Danek, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, David E Kandzari, Nicholas J Lembo, Mitul Patel, Ehtisham Mahmud, William L Lombardi, R Michael Wyman, J Aaron Grantham, Anthony H Doing, Catalin Toma, James W Choi, Barry F Uretsky, Jeffrey W Moses, Ajay J Kirtane, Ziad A Ali, Manish Parikh, Judit Karacsonyi, Bavana V Rangan, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: We sought to determine the effect of age and sex on procedural outcomes and efficiency of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We examined the clinical and angiographic characteristics and outcomes of 1675 CTO-PCIs performed in 1644 patients between 2012 and 2016 at 15 United States centers. RESULTS: Mean age was 65.3 ± 10 years and 1408 (86%) were men. Overall technical and procedural success rates were 88% and 87%, respectively...
January 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28089779/percutaneous-coronary-intervention-of-chronically-occluded-saphenous-vein-grafts-using-excimer-laser-atherectomy-as-an-adjuvant-therapy
#5
Mohsen Mohandes, Sergio Rojas, Mauricio Torres, Cristina Moreno, Francisco Fernández, Jordi Guarinos, Alfredo Bardají
We present two cases with chronic total occlusion of the saphenous vein graft in two patients with a history of previous bypass surgery with unfavorable anatomic features for recanalization of the native coronary artery. In the first case, two dedicated attempts for recanalization of chronic total occlusion of the native artery failed and in the second case there was not an adequate visualization of the native vessel beyond the occlusion point, not even by contralateral injection. Excimer laser atherectomy was used in both cases as an adjuvant therapy during recanalization of the saphenous vein graft in combination with a distal protection device in order to reduce distal embolization...
December 27, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28089148/percutaneous-revascularization-of-chronic-total-occlusions-rationale-indications-techniques-and-the-cardiac-surgeon-s-point-of-view
#6
Lorenzo Azzalini, Gianluca Torregrossa, John D Puskas, Emmanouil S Brilakis, William L Lombardi, Dimitri Karmpaliotis, Sunao Nakamura, Antonio Colombo, Mauro Carlino
Chronic total occlusions (CTO) are frequently found in clinical practice, yet they are still undertreated, despite the frequent presence of clinical indications for revascularization. The presence of a CTO is a frequent cause of incomplete revascularization, which has been associated with worse long-term outcomes (including mortality), compared to complete revascularization. Such low rates of attempted revascularization can be attributed to a common misconception about the lack of benefit of CTO revascularization, combined with historically lower success rates and higher complication rates of CTO percutaneous coronary intervention...
January 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28066662/-spiral-stenting-creating-a-subintimal-neo-luminal-helix-around-a-massively-calcified-ostial-chronic-total-occlusion-of-the-right-coronary-artery-in-a-patient-with-recurrent-ventricular-tachycardia
#7
Kambis Mashayekhi, Zivile Valuckiene, Hans Neuser, Marlon Walter, Wolfgang Gappmaier, Thomas Kaiser, Franz-Josef Neumann, Ibrahim Akin, Michael Behnes
This case report describes a successful percutaneous coronary intervention (PCI) of a severely calcified aorto-ostial chronic total occlusion (CTO) of the right coronary artery (RCA). The lesion was treated by a retrograde approach implementing long spiral subintimal wire tracking and final coronary stenting creating a subintimal neo-luminal helix around the natively occluded RCA. After 6 months of follow-up valuable angiographic results were proven.
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28044983/chronic-total-occlusion-in-non-infarct-related-artery-is-closely-associated-with-increased-five-year-mortality-in-patients-with-st-segment-elevation-acute-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-from-the-credo-kyoto-ami-registry
#8
Hiroki Watanabe, Takeshi Morimoto, Hiroki Shiomi, Yutaka Furukawa, Yoshihisa Nakagawa, Kenji Ando, Kazushige Kadota, Takeshi Kimura
AIMS: We sought to investigate the clinical impact of chronic total occlusion (CTO) in non-infarct-related artery (IRA) on long-term cardiovascular outcomes in patients with ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS: Among 5429 patients enrolled in the CREDO-Kyoto AMI registry, the current study population consisted of 2045 STEMI patients with multi-vessel disease (MVD) who underwent primary PCI within 24 hours after the symptom onset. The cumulative 5-year, 30-day and 30-day-to-5-year incidences of all-cause death were all significantly higher in the CTO group than in the non-CTO group (37...
January 3, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28041697/validity-of-the-j-cto-score-and-the-cl-score-for-predicting-successful-cto-recanalization
#9
J E Guelker, L Bansemir, R Ott, T Rock, K Kroeger, R Guelker, H G Klues, D I Shin, A Bufe
BACKGROUND: Percutaneous coronary intervention (PCI) of total chronic coronary occlusion (CTO) still remains a major challenge in interventional cardiology. To predict the probability of a successful intervention different scoring systems are available. We analyzed in this study the validity of two scoring systems, the Japanese CTO score (J-CTO score) and the newly developed Clinical and Lesion-related score (CL Score). METHODS: Between 2012 and 2015 we included 379 consecutive patients...
December 27, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28040288/collateral-filling-efficiency-of-comorbid-chronic-total-occlusion-segment-on-short-term-mortality-in-st-elevation-myocardial-infarction
#10
Toshiharu Fujii, Masataka Nakano, Yohei Ohno, Gaku Nakazawa, Norihiko Shinozaki, Takashi Matsukage, Fuminobu Yoshimachi, Yuji Ikari
BACKGROUND: Collateral filling of chronic total occlusion (CTO) segments is considered to affect hemodynamic stability in primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) with CTO, however its value as a prognostic indicator for mortality is uncertain. The present study examined the relationship between collateral filling of CTO segments and short-term mortality in patients with STEMI with a comorbid CTO lesion. METHODS: Among 829 STEMI patients who underwent primary PCI, 74 patients with CTO were identified...
December 21, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28031659/successful-percutaneous-coronary-intervention-for-chronic-total-occlusion-of-left-anterior-descending-coronary-artery-in-a-patient-with-dextrocardia
#11
Ozlem Ozcan Celebi, Bulent Deveci, Erdogan Ilkay
Dextrocardia is a rare cardiac anomaly in which the heart is located in the right chest along with the cardiac long axis directing to the right and inferiorly. Although, it is a rare clinical phenomenon, coronary artery disease with dextrocardia is presumed to be of similar frequency as in the general population. Percutaneous coronary intervention has some technical difficulties in these patients. We hereby report a male patient with dextrocardia who was previously treated with coronary artery bypass graft surgery...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28029214/long-term-outcomes-of-rotational-atherectomy-for-the-percutaneous-treatment-of-chronic-total-occlusions
#12
Lorenzo Azzalini, Rustem Dautov, Soledad Ojeda, Antonio Serra, Susanna Benincasa, Barbara Bellini, Francesco Giannini, Jorge Chavarría, Livia L Gheorghe, Manuel Pan, Mauro Carlino, Antonio Colombo, Stéphane Rinfret
OBJECTIVES: To study the long-term outcomes of rotational atherectomy (RA) for chronic total occlusion (CTO) percutaneous coronary intervention (PCI). BACKGROUND: There is little evidence on the incidence, procedural results and long-term outcomes of RA for CTO PCI. METHODS: This registry included data from consecutive patients undergoing CTO PCI at four specialized centers. Major adverse cardiac events (MACE: cardiac death, target-vessel myocardial infarction and ischemia-driven target-vessel revascularization) on follow-up were the primary endpoint...
December 28, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28004266/long-term-major-adverse-cardiac-and-cerebrovascular-events-macce-rate-comparison-of-retrograde-and-antegrade-recanalization-of-chronic-total-coronary-occlusions
#13
Klaudija Bijuklic, Carsten Schwencke, Joachim Schofer
BACKGROUND: The recanalization success rate of chronic total occlusion (CTO) percutaneous coronary interventions (PCI) can be increased by the retrograde approach; however, the long-term outcome of patients undergoing retrograde procedures is unknown. AIM: We aimed to evaluate the long-term major adverse cardiac and cerebrovascular event (MACCE) rate (e.g. death, myocardial infarction, coronary artery bypass surgery and stroke) in patients after retrograde versus antegrade CTO-PCI...
December 21, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27986755/impact-of-incomplete-percutaneous-revascularization-in-patients-with-multivessel-coronary-artery-disease-a-systematic-review-and-meta-analysis
#14
Vinayak Nagaraja, Sze-Yuan Ooi, James Nolan, Adrian Large, Mark De Belder, Peter Ludman, Rodrigo Bagur, Nick Curzen, Takashi Matsukage, Fuminobu Yoshimachi, Chun Shing Kwok, Colin Berry, Mamas A Mamas
BACKGROUND: Up to half of patients undergoing percutaneous coronary intervention have multivessel coronary artery disease (MVD) with conflicting data regarding optimal revascularization strategy in such patients. This paper assesses the evidence for complete revascularization (CR) versus incomplete revascularization in patients undergoing percutaneous coronary intervention, and its prognostic impact using meta-analysis. METHODS AND RESULTS: A search of PubMed, EMBASE, MEDLINE, Current Contents Connect, Google Scholar, Cochrane library, Science Direct, and Web of Science was conducted to identify the association of CR in patients with multivessel coronary artery disease undergoing percutaneous coronary intervention with major adverse cardiac events and mortality...
December 16, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27974669/initial-experience-of-bioabsorbable-polymer-everolimus-eluting-synergy-stents-in-high-risk-patients-undergoing-complex-percutaneous-coronary-intervention-with-early-discontinuation-of-dual-antiplatelet-therapy
#15
Rebecca L Noad, Colm G Hanratty, Simon J Walsh
AIMS: As more elderly and co-morbid patients require percutaneous revascularization, 1 year of dual-antiplatelet therapy (DAPT) becomes concerning. Synergy stents (Boston Scientific) allow for early cessation of DAPT. This study assessed those in our unit who underwent percutaneous coronary intervention (PCI) with a Synergy stent to examine a minimum of 6 months of clinical outcomes after early discontinuation of DAPT. METHODS AND RESULTS: All non-trial patients in our unit who had PCI with a Synergy stent from August 2013 to February 2016 were retrospectively analyzed...
15, 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27970358/tct-188-the-impact-of-the-location-on-left-ventricular-function-in-st-elevation-myocardial-infarction-patients-with-a-chronic-total-occlusion-in-a-non-infarct-related-artery-treated-with-percutaneous-coronary-intervention
#16
Joelle Elias, Ivo van Dongen, Loes Hoebers, Dagmar Ouweneel, Bimmer Claessen, Jose Henriques
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970339/tct-16-patient-and-procedural-characteristics-and-in-hospital-outcomes-associated-with-the-use-of-retrograde-recanalization-techniques-for-chronic-total-occlusion-pci-a-report-from-the-open-cto-registry
#17
Sanjog Kalra, James Sapontis, Robert Riley, Mohammed Qintar, Philip Jones, Ajay Kirtane, Manish Parikh, Jeffrey Moses, Ziad Ali, William Lombardi, William Nicholson, J Aaron Grantham, Dimitri Karmpaliotis
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970318/tct-149-impact-of-chronic-total-occlusion-in-a-non-infarct-related-artery-on-clinical-outcomes-in-patients-undergoing-primary-percutanous-coronary-intervention-analysis-of-a-8-year-all-comers-prospective-registry
#18
Ana Belen Cid Alvarez, Alfredo Redondo Dieguez, Carlos Galvao Braga, Ramiro Trillo, Diego Lopez Otero, Raymundo Ocaranza-Sanchez, Belen Alvarez Alvarez, Kieran Docherty, Jose Ramon González-Juanatey
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970313/tct-13-outcomes-of-chronic-total-occlusion-percutaneous-coronary-intervention-according-to-dissection-re-entry-versus-wire-escalation-techniques
#19
Lorenzo Azzalini, Rustem Dautov, Soledad Ojeda, Barbara Bellini, Susanna Benincasa, Jorge Chavarria Viquez, Manuel Pan, Mauro Carlino, Antonio Colombo, Stéphane Rinfret
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970312/tct-14-specialist-chronic-total-occlusion-cto-programmes-and-outcomes-after-cto-percutaneous-coronary-interventions-an-observational-study-of-5-496-patients-from-the-pan-london-cto-cohort
#20
Daniel Jones, Krishnaraj Rathod, Roshan Weerackody, Andrew Wragg, Elliot Smith
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
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