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chronic total occlusion pci

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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/28214141/feasibility-and-safety-of-same-day-discharge-after-complex-percutaneous-coronary-intervention-using-forearm-approach
#2
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
#3
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
https://www.readbyqxmd.com/read/28185704/everolimus-versus-zotarolimus-eluting-stent-following-percutaneous-coronary-chronic-total-occlusion-intervention
#4
Pil Hyung Lee, Min Soo Cho, Seung-Whan Lee, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
BACKGROUND: Although studies have demonstrated comparable efficacy and safety profiles of everolimus- and zotarolimus-eluting stents (EES and ZES, respectively) for a broad spectrum of coronary artery diseases, there is paucity of data concerning their safety and efficacy for coronary chronic total occlusions (CTOs). This study compared the clinical performance of EES and ZES following successful percutaneous coronary intervention for CTOs. METHODS: The cohort included 539 consecutive CTO patients who underwent successful PCI using EES (n=313) and ZES (n=226) between September 2006 and August 2014...
February 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28185396/primary-percutaneous-coronary-intervention-of-native-chronic-total-occlusions-to-treat-st-elevation-myocardial-infarction-secondary-to-acute-vein-graft-occlusion
#5
Pierre Deharo, Julian W Strange, Abdul Mozid
Primary percutaneous coronary intervention (PCI) is the treatment modality of choice in patients presenting with ST elevation myocardial infarction (STEMI). Clinical outcomes have dramatically improved with the wide adoption of primary PCI in patients with STEMI because of acute thrombotic native coronary artery occlusion. However, patients with prior coronary artery bypass graft (CABG) surgery who present with STEMI because of acute saphenous vein graft (SVG) occlusion continue to have worse outcomes because of poor acute and long-term results of SVG stenting...
February 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28183464/transradial-coronary-interventions-for-complex-chronic-total-occlusions
#6
Yutaka Tanaka, Noriaki Moriyama, Tomoki Ochiai, Takuma Takada, Kazuki Tobita, Koki Shishido, Kazuya Sugitatsu, Futoshi Yamanaka, Shingo Mizuno, Masato Murakami, Junya Matsumi, Saeko Takahashi, Takeshi Akasaka, Shigeru Saito
OBJECTIVES: The aims of this study were to assess whether the transradial approach can be applied to treat complex chronic total occlusion (CTO) and to determine the predictors of transradial percutaneous coronary intervention (PCI) failure. BACKGROUND: Consistent data on the outcomes of transradial PCI for treating CTO are scarce. METHODS: Consecutive patients who were not receiving hemodialysis and had undergone PCI for CTO were enrolled...
February 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28169213/long-term-clinical-outcomes-of-patients-with-coronary-chronic-total-occlusion-treated-with-percutaneous-coronary-intervention-versus-medical-therapy-according-to-presence-of-diabetes-mellitus
#7
Ki Hong Choi, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Hyeon-Cheol Gwon, Sang Hoon Lee, Seung-Hyuk Choi
AIMS: The aim of this study was to compare the long-term clinical outcomes of patients with chronic total occlusion (CTO) treated with percutaneous coronary intervention (PCI) versus medical therapy (MT) according to the presence of diabetes mellitus. METHODS AND RESULTS: A total of 845 patients without diabetes and 702 patients with diabetes were included from the Samsung Medical Center CTO registry. The inverse probability of treatment weighted (IPTW) method was used to adjust for confounding factors...
February 7, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28169091/predictors-of-excess-patient-radiation-exposure-during-chronic-total-occlusion-coronary-intervention-insights-from-a-contemporary-multicentre-registry
#8
Georgios E Christakopoulos, Georgios Christopoulos, Dimitri Karmpaliotis, Khaldoon Alaswad, Robert W Yeh, Farouc A Jaffer, Michael R Wyman, William L Lombardi, Muhammad Nauman J Tarar, J Aaron Grantham, David E Kandzari, Nicholas Lembo, Jeffrey W Moses, Ajay J Kirtane, Manish Parikh, Philip Green, Matthew Finn, Santiago Garcia, Anthony H Doing, Raja Hatem, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: High patient radiation dose during chronic total occlusion (CTO) percutaneous coronary intervention (PCI) might lead to procedural failure and radiation skin injury. METHODS: We examined the association between several clinical and angiographic variables on patient air kerma (AK) radiation dose among 748 consecutive CTO PCIs performed at 9 experienced US centres between May 2012 and May 2015. RESULTS: The mean age was 65 ± 10 years, 87% of patients were men, and 35% had previous coronary artery bypass graft surgery (CABG)...
November 11, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28164433/coronary-artery-aneurysm-after-implantation-of-a-bioresorbable-vascular-scaffold-case-report-and-literature-review
#9
Su-Kiat Chua, Jun-Jack Cheng
A 55-year-old man underwent successful percutaneous coronary intervention for the middle left circumflex artery with a 3.5 × 28-mm bioresorbable vascular scaffold (BVS). At 18 months, follow-up coronary angiography showed ectatic change with aneurysm formation over the BVS. Optical coherence tomography revealed absence of strut continuity at the aneurysm site, in the middle of the BVS. A literature review identified nine patients with intrascaffold aneurysm, including the present patient, which developed 6-32 months after BVS implantation...
February 6, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28149318/efficacy-and-safety-of-tornus-catheter-in-percutaneous-coronary-intervention-of-hard-or-balloon-uncrossable-chronic-total-occlusion
#10
Mohsen Mohandes, Sergio Rojas, Jordi Guarinos, Francisco Fernández, Xavier Oliva, Marianela Noueched, Alfredo Bardaji
BACKGROUND: Balloon advancement and dilation through chronic total occlusion segment could be challenging in some cases after successful wire crossing. The purpose of this study was to evaluate efficacy and safety of Tornus catheter (Asahi Intecc; Aichi, Japan) in percutaneous coronary intervention of chronic total occlusion in hard or balloon-uncrossable chronic total occlusion. METHODS: The present study is a retrospective and descriptive analysis of 14 hard or balloon-uncrossable chronic total occlusions treated percutaneously in our catheterization laboratory (cath lab)...
July 2016: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/28145879/late-double-barrel-lumen-following-successful-cto-pci-using-the-crossboss-stingray-system
#11
James Roy, David Rees, David Ramsay, James Weaver
There remains limited randomized controlled trials on long-term clinical outcomes after chronic total occlusion percutaneous coronary intervention (CTO-PCI). New techniques involving dissection of the subintimal space and reentry into the true lumen increase success rates in CTO-PCI. However, their longer-term safety and efficacy remain unknown and poorly studied. We present a case of double-lumen formation seen at 1 year post CTO-PCI using subintimal dissection reentry with late restoration of major side branches...
February 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28145612/coronary-artery-perforations-after-contemporary-percutaneous-coronary-interventions-evaluation-of-incidence-risk-factors-outcomes-and-predictors-of-mortality
#12
Jessica Parsh, Milan Seth, Jacqueline Green, Nadia R Sutton, Stanley Chetcuti, Simon Dixon, Paul M Grossman, Akshay Khandelwal, James M Dupree, Hitinder S Gurm
OBJECTIVES: We sought to evaluate the incidence, risk factors, in-hospital, and long-term outcomes and predictors of mortality of coronary artery perforations (CAP) in the contemporary percutaneous coronary intervention (PCI) era. BACKGROUND: CAP is a rare but serious complication of PCI associated with increased risk of morbidity and mortality. METHODS: We included 181,590 procedures performed across 47 hospitals in Michigan from January 1, 2010 to December 31, 2015...
February 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28127221/embolization-of-a-septal-branch-perforation-using-subcutaneous-fat-during-a-percutaneous-coronary-intervention-of-chronic-total-occlusion-by-retrograde-approach
#13
Mohsen Mohandes, Sergio Rojas, Jordi Guarinos, Judit Rodríguez, Francisco Fernández, Cristina Moreno, Alfredo Bardají
We describe a case of septal branch perforation during percutaneous coronary intervention of a right coronary artery chronic total occlusion. The septal branch perforation was treated with administration of autologous fat into the septal branch with significant reduction of extravasation. This treatment was followed by prolonged balloon inflation at the exit point of the septal branch in the donor artery which definitively sealed the perforation.
January 2017: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/28120559/the-effect-of-sex-and-anthropometry-on-clinical-outcomes-in-patients-undergoing-percutaneous-coronary-intervention-for-complex-coronary-lesions
#14
Seung Yul Lee, Dong Ho Shin, Jung Sun Kim, Byeong Keuk Kim, Young Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong Ki Hong
PURPOSE: To evaluate the effects of sex and anthropometry on clinical outcomes in patients who underwent percutaneous coronary intervention (PCI). MATERIALS AND METHODS: From three randomized trials (REal Safety and Efficacy of 3-month dual antiplatelet Therapy following Endeavor zotarolimus-eluting stent implantation, Impact of intraVascular UltraSound guidance on outcomes of Xience Prime stents in Long lesions, Chronic Total Occlusion InterVention with drUg-eluting Stents), we compared 333 pairs of men and women matched by propensity scores, all of whom underwent intravascular ultrasound (IVUS)-guided PCI for complex lesions...
March 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28115803/retrograde-approach-is-as-effective-and-safe-as-antegrade-approach-in-contemporary-percutaneous-coronary-intervention-for-chronic-total-occlusion-a-taiwan-single-center-registry-study
#15
Chih-Kuo Lee, Ying-Hsien Chen, Mao-Shin Lin, Chih-Fan Yeh, Chi-Sheng Hung, Hsien-Li Kao, Ching-Chang Huang
BACKGROUND: In percutaneous coronary intervention (PCI) for chronic total occlusion (CTO), most experts regard the antegrade approach as the default initial strategy, reserving the retrograde approach for reattempts following antegrade failure. In this study, we aimed to compare the efficacy and safety between the antegrade and retrograde approaches in CTO PCI. RESULTS: Between 2012 and 2013, patients that underwent 321 consecutive attempts by high-volume operators (> 75 total CTO PCI cases during the period) in a tertiary university-affiliated hospital were enrolled...
January 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28112479/a-novel-stent-inflation-protocol-improves-long-term-outcomes-compared-with-rapid-inflation-deflation-deployment-method
#16
Srikanth Vallurupalli, Srikanth Kasula, Shiv Kumar Agarwal, Naga Venkata K Pothineni, Amjad Abualsuod, Abdul Hakeem, Zubair Ahmed, Barry F Uretsky
BACKGROUND: High-pressure inflation for coronary stent deployment is universally performed. However, the duration of inflation is variable and does not take into account differences in lesion compliance. We developed a standardized "pressure optimization protocol" (POP) using inflation pressure stability rather than an arbitrary inflation time or angiographic balloon appearance for stent deployment. Whether this approach improves long-term outcomes is unknown. METHODS AND RESULTS: 792 patients who underwent PCI using either rapid inflation/deflation (n = 376) or POP (n = 416) between January 2009 and March 2014 were included...
January 23, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28112448/reduction-of-radiation-exposure-during-complex-interventions-for-chronic-total-coronary-occlusions-implementing-low-dose-radiation-protocols-without-affecting-procedural-success-rates
#17
Gerald S Werner, Peggy Glaser, Anja Coenen, Hiller Moehlis, Karl-Heinz Tischer, Matthias Koch, Reinhold Klingenbeck
BACKGROUND: The increasing complexity of percutaneous coronary intervention (PCI) for chronic total coronary occlusions (CTO) leads to a significant increase of radiation exposure for both patient and operator. OBJECTIVE: To study the potential of modified settings of the X-ray equipment combined with operator protocols to reduce radiation dose despite increasing procedural complexity. PATIENTS AND METHODS: We analyzed a consecutive cohort of 984 PCIs for CTOs in 863 patients between January 2010 and July 2015...
January 23, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28111398/survey-of-exposure-dose-during-percutaneous-coronary-intervention-for-chronic-total-occlusion
#18
Tomokazu Sakano, Tatsushi Iwamoto, Takuya Kuribara, Hajime Sakamoto, Osamu Tajima, Yasuatu Hamano, Masayuki Maruyama, Tatsuya Kikuchi, Atsuko Tsukamoto, Kyouichi Kato
During percutaneous coronary intervention (PCI) for chronic total occlusion (CTO), longer fluoroscopic time as compared with PCI for non-CTO lesions may cause skin injury by increased radiation. We have performed a multi-center observational study comparing the exposed dose during the PCI of CTO (CTO group) and during the PCI of non-CTO lesions (non-CTO group). Exposure doses were assessed in 313 patients with CTO and 3,310 patients with non-CTO lesions. Total fluoroscopy time (59.0 ±35.5 vs 26.8 ±18.8 min, p<0...
2017: Nihon Hoshasen Gijutsu Gakkai Zasshi
https://www.readbyqxmd.com/read/28105600/approach-to-cto-intervention-overview-of-techniques
#19
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
#20
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...
February 7, 2017: International Heart Journal
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