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chronic total occlusion pci

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https://www.readbyqxmd.com/read/28648437/utility-of-adjunctive-modalities-in-coronary-chronic-total-occlusion-intervention
#1
REVIEW
Hemal Bhatt, Sean Janzer, Jon C George
Coronary chronic total occlusion (CTO) intervention remains one of the most challenging domains in interventional cardiology. Due to the technical challenges involved and potential procedural complications, CTO percutaneous coronary intervention (PCI) attempt and success rates remain less than standard PCI. However, the use of several adjunctive tools such as intravascular ultrasound, optical coherence tomography, rotational atherectomy, orbital atherectomy, excimer laser coronary atherectomy and percutaneous left ventricular assist device may contribute to improved CTO PCI success rates or provide better hemodynamic assessment of CTO lesion (i...
May 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28625964/antegrade-dissection-and-reentry-as-part-of-the-hybrid-chronic-total-occlusion-revascularization-strategy-a-subanalysis-of-the-recharge-registry-registry-of-crossboss-and-hybrid-procedures-in-france-the-netherlands-belgium-and-united-kingdom
#2
Joren Maeremans, Jo Dens, James C Spratt, Alan J Bagnall, Wynand Stuijfzand, Alexander Nap, Pierfrancesco Agostoni, William Wilson, Colm G Hanratty, Simon Wilson, Benjamin Faurie, Alexandre Avran, Erwan Bressollette, Mohaned Egred, Paul Knaapen, Simon Walsh
BACKGROUND: Development of the CrossBoss and Stingray devices for antegrade dissection and reentry (ADR) of chronic total occlusions has improved historically suboptimal outcomes. However, the outcomes, safety, and failure modes of the technique have to be studied in a larger patient cohort. This preplanned substudy of the RECHARGE registry (Registry of CrossBoss and Hybrid Procedures in France, the Netherlands, Belgium and United Kingdom) aims to evaluate the value and use of ADR and determine its future position in contemporary chronic total occlusion intervention...
June 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28624404/accuracy-of-j-cto-score-derived-from%C3%A2-computed-tomography-versus-angiography-to-predict-successful-percutaneous-coronary-intervention
#3
Akiko Fujino, Satoru Otsuji, Katsuyuki Hasegawa, Toyohiro Arita, Shin Takiuchi, Kenichi Fujii, Masanori Yabuki, Motoaki Ibuki, Shinya Nagayama, Kasumi Ishibuchi, Toshikazu Kashiyama, Rui Ishii, Hiroto Tamaru, Wataru Yamamoto, Masahiko Hara, Yorihiko Higashino
OBJECTIVES: The aim of this study was to compare the ability of conventional versus computed tomography angiography (CTA) to predict procedural success and 30-min wire crossing rates in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions. BACKGROUND: Coronary CTA can be used to assess the morphology of CTO lesions. METHODS: We examined 205 consecutive patients (218 CTO lesions) who underwent coronary CTA pre-PCI...
June 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28616560/successful-revascularization-improves-long-term-clinical-outcome-in-patients-with-chronic-coronary-total-occlusion
#4
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/28612905/treatment-of-coronary-chronic-total-occlusion-by-transradial-approach-current-trends-and-expert-recommendations
#5
Leszek Bryniarski, Michał Zabojszcz, Krzysztof Leszek Bryniarski
The aim of this review is to highlight the technical details and the scientific data on percutaneous coronary interventions (PCIs) in chronic total occlusion (CTO) performed by transradial approach (TRA). Transfemoral approach (TFA) is commonly regarded as the standard for CTO PCI, but there are a growing number of CTO recanalization procedures performed by TRA. We discuss the relevant technical details to approach a CTO by transradial access, especially the compatibility of various CTO recanalization techniques with specific guiding catheter sizes...
June 14, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28595879/predictors-of-successful-hybrid-approach-chronic-total-coronary-artery-occlusion%C3%A2-stenting-an-improved-model-with-novel-correlates
#6
Stephen G Ellis, M Nicholas Burke, M Bilal Murad, John J Graham, Ramy Badawi, Catelin Toma, Henry Meltser, Ravi Nair, Chris Buller, Patrick L Whitlow
OBJECTIVES: The aim of this study was to develop a hybrid approach-specific model to predict chronic total coronary artery occlusion (CTO) percutaneous coronary intervention success, useful for experienced but not ultra-high-volume operators. BACKGROUND: CTO percutaneous coronary intervention success rates vary widely and have improved with the "hybrid approach," but current predictive models for success have major limitations. METHODS: Data were obtained from consecutively attempted patients from 7 clinical sites (9 operators, mean annual CTO volume 61 ± 17 cases)...
June 12, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28588825/a-presentation-of-postcardiac-injury-syndrome-after-successful-chronic-total-occlusion-percutaneous-coronary-intervention-using-dissection-re-entry-techniques
#7
Gabby Elbaz-Greener, Harindra C Wijeysundera
Retrograde dissection re-entry can cause pericardial trauma of sufficient degree to lead to the development of an auto-immune postpericardial injury syndrome. Clinical suspicion for this condition should be high in the event of fever, symptoms, pericardial/pleural effusion, and pleuritic chest pain following chronic total occlusion (CTO) Post cardiac injury syndromes (PCI).
June 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28570257/the-impact-of-proximal-vessel-tortuosity-on-the-outcomes-of-chronic-total-occlusion-percutaneous-coronary-intervention-insights-from-a-contemporary-multicenter-registry
#8
Judit Karacsonyi, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, Ehtisham Mahmud, Anthony Doing, Catalin Toma, Barry Uretsky, James Choi, Jeffrey W Moses, Ajay Kirtane, Manish Parikh, Ziad Ali, William L Lombardi, David E Kandzari, Nicholas Lembo, Santiago Garcia, Michael R Wyman, Jose R Martinez-Parachini, Aris Karatasakis, Barbara A Danek, Aya J Alame, Erica Resendes, Bavana V Rangan, Imre Ungi, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
INTRODUCTION: We examined the impact of proximal vessel tortuosity on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: The baseline clinical and angiographic characteristics and procedural outcomes of 1618 consecutive CTO-PCIs performed between 2012 and 2016 at 14 United States centers in 1589 patients were reviewed. RESULTS: Mean patient age was 65.3 ± 10.0 years and 85% were men. Moderate/severe proximal vessel tortuosity was present in 35...
May 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28570234/impact-of-the-occlusion-duration-on-the-performance-of-j-cto-score-in-predicting-failure-of-percutaneous-coronary-intervention-for-chronic-total-occlusion
#9
Antonio de Castro-Filho, Edgar Stroppa Lamas, Rafael A Meneguz-Moreno, Rodolfo Staico, Dimytri Siqueira, Ricardo A Costa, Sergio N Braga, J Ribamar Costa, Daniel Chamié, Alexandre Abizaid
OBJECTIVES: The present study examined the association between Multicenter CTO Registry in Japan (J-CTO) score in predicting failure of percutaneous coronary intervention (PCI) correlating with the estimated duration of chronic total occlusion (CTO). BACKGROUND: The J-CTO score does not incorporate estimated duration of the occlusion. METHODS: This was an observational retrospective study that involved all consecutive procedures performed at a single tertiary-care cardiology center between January 2009 and December 2014...
June 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28567361/unexpected-evolution-of-a-non-stenotic-lesion-in-the-left-main-coronary-artery-of-a-patient-with-non-st-segment-elevation-myocardial-infarction
#10
Alexandru Florin Ispas, Lionel Mangin, Alexandru Paziuc, Loic Belle
A 72-year-old man was referred to our catheterization laboratory 48 hours after a non-ST-segment elevation myocardial infarction. His medical history included coronary artery disease (CAD) (percutaneous coronary intervention of the right coronary artery and chronic total occlusion of the circumflex artery), atrial fibrillation (AF), and chronic kidney disease. An electrocardiogram showed a pre-existent left bundle-branch block and the patient's maximum cardiac troponin concentration was 8.64 µg/L (upper limit of normal: 0...
June 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28566934/a-novel-risk-score-in-predicting-failure-or-success-for-antegrade-approach-to-percutaneous-coronary-intervention-of-chronic-total-occlusion-antegrade-cto-score
#11
Mohammad Hasan Namazi, Ali Reza Serati, Hosein Vakili, Morteza Safi, Saeed Ali Pour Parsa, Habibollah Saadat, Maryam Taherkhani, Sepideh Emami, Shamseddin Pedari, Masoomeh Vatanparast, Mohammad Reza Movahed
Total occlusion of a coronary artery for more than 3 months is defined as chronic total occlusion (CTO). The goal of this study was to develop a risk score in predicting failure or success during attempted percutaneous coronary intervention (PCI) of CTO lesions using antegrade approach. This study was based on retrospective analyses of clinical and angiographic characteristics of CTO lesions that were assessed between February 2012 and February 2014. Success rate was defined as passing through occlusion with successful stent deployment using an antegrade approach...
June 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28562382/impact-of-mean-platelet-aggregation-degree-on-long-term-clinical-outcomes-among-patients-undergoing-a-complex-percutaneous-coronary-intervention
#12
Quan Li, Mengmeng Li, Xianpeng Yu, Jiqiang He, Yuechun Gao, Xiaoling Zhang, Changyan Wu, Yawei Luo, Yuchen Zhang, Xuejun Ren
OBJECTIVE: The aim of this study was to evaluate the association between the mean platelet aggregation degree and long-term clinical outcomes in patients receiving a complex percutaneous coronary intervention (CPCI). PATIENTS AND METHODS: We screened 2141 patients after a percutaneous coronary intervention (PCI) treated with aspirin and clopidogrel. CPCI was defined as a procedure targeted to at least one of the following: left main disease, bifurcation lesion, ostial lesion, chronic total occlusion, and small-vessel stenting...
May 30, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28539570/usefulness-and-safety-of-a-novel-modification-of-the-retrograde-approach-for-the-long-tortuous-chronic-total-occlusion-of-coronary-arteries
#13
Zehan Huang, Bin Zhang, Weilu Chai, Dunliang Ma, Hongtao Liao, Zhian Zhong, Feng Wang, Jingye Lin
The aim of this study was to evaluate the feasibility and efficacy of the Guidezilla guide extension catheter in a reverse controlled antegrade and retrograde subintimal tracking (CART) technique for chronic total occlusion (CTO) recanalization.We retrospectively collected 80 CTO cases using reverse CART technology from January 2015 to October 2015 and 20 CTO cases using Guidezilla reverse-CART technology from October 2015 to March 2016. Guidezilla was applied in cases when it was difficult to advance a retro-guidewire through an occlusion segment into the antegrade guide catheter...
May 23, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28537939/current-perspectives-on-revascularization-in-multivessel-st-elevation-myocardial-infarction
#14
Guy Witberg, Ran Kornowski
Up to 50% of patients presenting with ST elevation myocardial infarction (STEMI) are found to have multivessel coronary artery disease. These patients have a worse prognosis compared with the overall STEMI population. Two revascularization strategies are possible for these patients: treating the infarct-related artery percutaneous coronary intervention (IRA-PCI) only or achieving Complete revascularization (CR), either through an immediate multivessel PCI during the index angiography or during a second-staged procedure...
May 19, 2017: Coronary Artery Disease
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
#15
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/28516401/endovascular-crossing-of-chronic-total-occlusions-using-an-impulse-an-explorative-design-study
#16
Aimée Sakes, Marleen van der Wiel, Dimitra Dodou, Paul Breedveld
In this study we investigated whether exerting an impulse on a Chronic Total Occlusion (CTO) improves the success rate of CTO crossing as compared to the currently used method of statically pushing the guidewire against the CTO. A prototype (Ø2 mm) was developed that generates translational momentum using a spring-loaded indenter and converts it to an impulse during impact. Mechanical performance was evaluated by measuring the peak force and momentum for different spring compressions and strike distances in air and blood-mimicking fluid...
June 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28515854/determinants-of-percutaneous-coronary-intervention-success-in-repeat-chronic-total-occlusion-procedures-following-an-initial-failed-attempt
#17
Cecilia Cuevas, Nicola Ryan, Alicia Quirós, Juan Gustavo Del Angel, Nieves Gonzalo, Pablo Salinas, Pilar Jiménez-Quevedo, Luis Nombela-Franco, Ivan Nuñez-Gil, Antonio Fernandez-Ortiz, Carlos Macaya, Javier Escaned
AIM: To investigate the rates and determinants of success of repeat percutaneous coronary intervention (PCI) following an initial failed attempt at recanalising the chronic total occlusions (CTO) percutaneously. METHODS: In 445 consecutive first attempt CTO-PCI procedures in our institution, procedural failure occurred in 149 (33.5%). Sixty-four re-PCI procedures were performed in 58 patients (39%) all had a single CTO. Procedural and outcome data in the re-PCI population was entered into the institutional database...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28504230/macedonia-coronary-and-structural-heart-interventions-from-2010-to-2015
#18
Sasko Kedev, Biljana Zafirovska, Oliver Kalpak, Slobodan Antov, Jorgo Kostov, Igor Spiroski, Hristo Pejkov, Marjan Boshev, Ivan Vasllev, Aleksandar Jovkovski, Hajber Taravari, Danica Petkoska, Darko Kitanoski
The aim of this report is to describe invasive cardiology procedural practice in Macedonia during the period from 2010 to 2015. Details of all consecutive 39,899 patients who underwent cardiovascular, peripheral or structural heart procedures during the period from 2010 until 2015 were examined. Clinical and procedure characteristics, access site, procedural success and complications were analysed. The number of coronary angiographies increased from 5,540 in 2010 to 8,550 in 2015. Transfemoral access (TFA) was present in 4% of coronary angiographies in 2010 and had decreased to 1% in 2015...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28500138/legacy-effect-of-coronary-perforation-complicating-percutaneous-coronary-intervention-for-chronic-total-occlusive-disease-an-analysis-of-26-807-cases-from-the-british-cardiovascular-intervention-society-database
#19
Tim Kinnaird, Richard Anderson, Nicholas Ossei-Gerning, James Cockburn, Alex Sirker, Peter Ludman, Mark deBelder, Simon Walsh, Elliot Smith, Colm Hanratty, James Spratt, Julian Strange, David Hildick-Smith, Mamas A Mamas
BACKGROUND: Coronary perforation (CP) during chronic total occlusion percutaneous coronary intervention for stable angina (CTO-PCI) is a rare but serious event. The evidence base is limited, and the long-term effects are unclear. Using a national PCI database, the incidence, predictors, and outcomes of CP during CTO-PCI were defined. METHODS AND RESULTS: Data analyzed from the British Cardiovascular Intervention Society data set on all CTO-PCI procedures performed in England and Wales between 2006 and 2013...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28499595/impact-of-calcium-on-chronic-total-occlusion-percutaneous-coronary-interventions
#20
Judit Karacsonyi, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, Ehtisham Mahmud, William Lombardi, Michael R Wyman, Anthony Doing, Jeffrey W Moses, Ajay Kirtane, Manish Parikh, Ziad Ali, David Kandzari, Nicholas Lembo, Santiago Garcia, Barbara A Danek, Aris Karatasakis, Erica Resendes, Pratik Kalsaria, Bavana V Rangan, Imre Ungi, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
We sought to examine the impact of calcific deposits on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The outcomes of 1,476 consecutive CTO PCIs performed in 1,453 patients (65.5 ± 10 years, 85% male) between 2012 and 2016 at 11 US centers were evaluated. Moderate or severe quantity of calcium was present in 58% of target lesions. Calcified lesions were more tortuous and more likely to have proximal cap ambiguity and interventional collaterals. PCI of moderately/severely calcified CTOs more often required use of the retrograde approach (54% vs 30%, p <0...
April 13, 2017: American Journal of Cardiology
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