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chronic total occlusion pci

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https://www.readbyqxmd.com/read/29628223/the-distal-left-radial-artery-access-for-coronary-angiography-and-intervention-a-new-era
#1
Karim M Al-Azizi, Amir S Lotfi
BACKGROUND: Patients' intra and post procedural comfort, quick recovery, as well as procedure success, are key elements for choosing the right arterial access site. Radial artery access has been of increasing interest since it was first described. Advanced treatments of coronary lesions, from primary percutaneous interventions during ST elevation myocardial infarction cases to chronic total occlusion cases, have been increasingly done through the radial access. Distal left trans radial artery (dlTRA) is a new technique first described by Kiemineij...
March 26, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29627112/impact-of-chronic-kidney-disease-on-outcomes-after-percutaneous-coronary-intervention-for-chronic-total-occlusions-from-the-japanese-multicenter-registry
#2
Toru Naganuma, Kenichi Tsujita, Satoru Mitomo, Hisaaki Ishiguro, Sandeep Basavarajaiah, Katsumasa Sato, Tsuyoshi Kobayashi, Junei Obata, Suguru Nagamatsu, Kenshi Yamanaga, Naohiro Komura, Kenji Sakamoto, Eiichiro Yamamoto, Yasuhiro Izumiya, Sunao Kojima, Koichi Kaikita, Hisao Ogawa, Sunao Nakamura
The impact of chronic kidney disease (CKD) and potential pharmacologic intervention on clinical outcomes after percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) remains unknown. A total of 1,463 patients underwent successful CTO-PCI between August 2004 and December 2014. Major adverse cardiovascular events (MACE) defined as the composite of all-cause death, myocardial infarction and target lesion revascularization, cardiac death, and stent thrombosis were compared between patients with and without CKD (555 and 908 patients, respectively)...
March 13, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29625510/interventional-management-of-balloon-uncrossable-coronary-chronic-total-occlusion-is-there-any-way-out
#3
REVIEW
Debabrata Dash
It has been estimated that coronary chronic total occlusion (CTO) is encountered in 15 to 20% patients referred for coronary angiography (CAG). The success of percutaneous coronary intervention (PCI) of CTO can be attributed to the vast array of hardware that has now become available and also to the vastly enhanced operator expertise. It is however realistic to state that despite the tremendous increase in the rate of success, there then comes a subset of CTO where PCI attempts fail. The reason for such failures given that other variables remain constant is the inability to cross the CTO lesion...
April 2018: Korean Circulation Journal
https://www.readbyqxmd.com/read/29623172/chronic-total-occlusion-coronary-intervention-in-search-of-a-definitive-benefit
#4
REVIEW
Alpesh Shah
Percutaneous coronary intervention (PCI) of chronic coronary total occlusion is the latest frontier in percutaneous intervention. There are vast improvements in the initial success and safety of the procedure as well as a better understanding of appropriateness and benefits. Advances in technology and skill allow for increased utilization of PCI in cases of chronic coronary total occlusion, with benefits regarding symptoms and quality of life. Percutaneous coronary intervention for chronic coronary total occlusion can correct ischemia and achieve complete revascularization while avoiding traditional coronary bypass grafting, although survival benefits remain unclear...
January 2018: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29605686/long-term-clinical-outcomes-of-optimal-medical-therapy-vs-successful-percutaneous-coronary-intervention-for-patients-with-coronary-chronic-total-occlusions
#5
Lei Guo, Lei Zhong, Kun Chen, Jian Wu, Rong-Chong Huang
OBJECTIVES: There are little data on the long-term clinical outcomes of optimal medical therapy (OMT) compared with successful percutaneous coronary intervention (PCI) in patients with chronic total occlusions (CTOs). METHODS: A total of 388 patients with ≥1 CTO were enrolled from January 2008 to December 2010. 62 patients were excluded, and 326 patients were divided into an OMT group (n = 125) and PCI group (n = 201) according to the initial treatment strategy...
March 29, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/29602581/macrophage-migration-inhibitory-factor-mif-is-associated-with-degree-of-collateralization-in-patients-with-totally-occluded-coronary-arteries
#6
Luigi Di Serafino, Jozef Bartunek, Guy Heyndrickx, Karen Dierickx, Gabriella Scognamiglio, Tullio Tesorio, Bernard De Bruyne, Bruno Trimarco, William Wijns, Emanuele Barbato
BACKGROUND: Collaterals in patients with coronary artery disease (CAD) limit myocardial infarction and improve survival. Macrophage migration inhibitory factor (MIF) might play a role in collateral development. We aimed this study to evaluate the association of Macrophage migration Inhibitory Factor (MIF) with the extent of collateralization in patients with coronary occlusion. METHODS AND RESULTS: We consecutively enrolled: a) 40 patients undergoing PCI of a chronic coronary total occlusion (CTO); b) 26 patients with ST-elevation myocardial infarction (STEMI) undergoing primary PCI (pPCI) of the infarct-related artery (IRA); c) 12 control patients undergoing angiography without significant coronary artery disease (CTRL)...
March 21, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29589974/coronary-chronic-total-occlusion-intervention-utility-or-futility
#7
Patrick Marechal, Laurent Davin, Olivier Gach, Christophe Martinez, Mathieu Lempereur, Nicolas Lhoest, Patrizio Lancellotti
Despite an incidence of about 18-52% of the patients undergoing coronary angiography, chronic total occlusions (CTO) are rarely revascularised by percutaneous angioplasty (PCI). Nevertheless, current evidence suggests that successful CTO angioplasty improves symptoms, quality of life and long-term survival. During the last decade, the improvement of specific tools and techniques for these complex procedures, and the increasing experience of operators, have led to the achievement of success and complication rates almost equivalent to non-CTO angioplasty...
March 28, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29572584/noise-reduction-technology-reduces-radiation-dose-in-chronic-total-occlusions-percutaneous-coronary-intervention-a-propensity-score-matched-analysis
#8
Davide Maccagni, Susanna Benincasa, Barbara Bellini, Luciano Candilio, Enrico Poletti, Mauro Carlino, Antonio Colombo, Lorenzo Azzalini
Chronic total occlusions (CTO) percutaneous coronary intervention (PCI) is associated with high radiation dose. Our study aim was to evaluate the impact of the implementation of a noise reduction technology (NRT) on patient radiation dose during CTO PCI. A total of 187 CTO PCIs performed between February 2016 and May 2017 were analyzed according to the angiographic systems utilized: Standard (n = 60) versus NRT (n = 127). Propensity score matching (PSM) was performed to control for differences in baseline characteristics...
March 23, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29569332/the-impact-of-coronary-chronic-total-occlusion-percutaneous-coronary-intervention-upon-donor-vessel-fractional-flow-reserve-and-instantaneous-wave-free-ratio-implications-for-physiology-guided-pci-in-patients-with-cto
#9
Shah R Mohdnazri, Grigoris V Karamasis, Firas Al-Janabi, Christopher M Cook, James Hampton-Till, Jufen Zhang, Rasha Al-Lamee, Jason N Dungu, Swamy Gedela, Kare H Tang, Paul A Kelly, Justin E Davies, John R Davies, Thomas R Keeble
OBJECTIVE: To investigate the immediate and short term impact of right coronary artery (RCA) chronic total coronary occlusion (CTO) percutaneous coronary intervention (PCI) upon collateral donor vessel fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR). BACKGROUND: CTO PCI influences collateral donor vessel physiology, making the indication and/or timing of donor vessel revascularization difficult to determine. METHODS: In patients with RCA CTO, FFR, iFR, and collateral function index (FFRcoll ) were measured in LAD and LCx pre-CTO PCI, immediately post and at 4 month follow-up...
March 22, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29563377/exploration-of-bivalirudin-use-during-percutaneous-coronary-intervention-for-high-bleeding-risk-patients-with-chronic-total-occlusion
#10
Chenguang Li, Yi Shen, Rende Xu, Yuxiang Dai, Shufu Chang, Hao Lu, Lei Ge, Jianying Ma, Juying Qian, Junbo Ge
The safety and efficacy of bivalirudin during percutaneous coronary intervention (PCI) in high bleeding risk patients with chronic total occlusion lesions (CTO) has not been studied till date. The use of bivalirudin may increase the thrombotic events during CTO-PCI.Between May 2013 and April 2014, a total of 117 high bleeding risk patients with CTOs underwent PCI. Bivalirudin was used in 89 cases with different strategies, including standard usage, combination of heparin, and additional bolus of bivalirudin on the basis of standard usage...
March 20, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29563016/impact-of-incomplete-revascularization-on-long-term-outcomes-following-chronic-total-occlusion-percutaneous-coronary-intervention
#11
Lorenzo Azzalini, Luciano Candilio, Soledad Ojeda, Joseph Dens, Alessio La Manna, Susanna Benincasa, Barbara Bellini, Francisco Hidalgo, Jorge Chavarría, Joren Maeremans, Giacomo Gravina, Eligio Miccichè, Guido D'Agosta, Giuseppe Venuti, Corrado Tamburino, Manuel Pan, Mauro Carlino, Antonio Colombo
We aimed to evaluate the impact of incomplete revascularization (ICR) on long-term outcomes of patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Consecutive patients undergoing CTO PCI at 4 centers were included. Baseline SYNTAX score (bSS: low [≤ 22], intermediate [>22 and <33], high [≥33]), residual SYNTAX score (rSS: 0, >0 and ≤8, >8), and SYNTAX revascularization index (SRI: 100 × (bSS-rSS)/bSS: 100%, 50% to 99%, <50%) were calculated. The primary end point was major adverse cardiac events (MACEs; cardiac death, any myocardial infarction, any revascularization) on follow-up...
February 23, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29550088/update-in-the-percutaneous-management-of-coronary-chronic-total-occlusions
#12
REVIEW
Peter Tajti, M Nicholas Burke, Dimitri Karmpaliotis, Khaldoon Alaswad, Gerald S Werner, Lorenzo Azzalini, Mauro Carlino, Mitul Patel, Kambis Mashayekhi, Mohaned Egred, Oleg Krestyaninov, Dmitrii Khelimskii, William J Nicholson, Imre Ungi, Alfredo R Galassi, Subhash Banerjee, Emmanouil S Brilakis
Percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) has been rapidly evolving during recent years. With improvement in equipment and techniques, high success rates can be achieved at experienced centers, although overall success rates remain low. Prospective, randomized-controlled data regarding optimal use and indications for CTO PCI remain limited. CTO PCI should be performed when the anticipated benefit exceeds the potential risk. New high-quality studies of the clinical outcomes and techniques of CTO PCI are needed, as is the expansion of expert centers and operators that can achieve excellent clinical outcomes in this challenging patient and lesion subgroup...
March 12, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29550046/usefulness-of-the-twin-guidewire-method-during-retrieval-of-the-broken-tip-of-a-microcatheter-entrapped-in-a-heavily-calcified-coronary-artery
#13
Sho Hashimoto, Akihiko Takahashi, Takeshi Yamada, Yukio Mizuguchi, Norimasa Taniguchi, Shunsuke Nakajima, Tetsuya Hata
During percutaneous coronary intervention performed for a stenotic lesion with heavy calcification in the left coronary artery, the microcatheter tip became transected in the vessel. The fragment was successfully retrieved using the twin guidewire method after negotiating to cross a chronic total occlusion-dedicated guidewire outside the retained tip.
February 23, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29529964/prevalence-of-chronic-kidney-disease-among-patients-undergoing-transradial-percutaneous-coronary-interventions
#14
Mohammad A Hossain, Amy Quinlan, Jennifer Heck-Kanellidis, Dawn Calderon, Tejas Patel, Bhavika Gandhi, Shrinil Patel, Mahida Hetavi, Eric J Costanzo, James Cosentino, Chirag Patel, Asa Dewan, Yen-Hong Kuo, Loay Salman, Tushar J Vachharajani
BACKGROUND: While transradial approach to conduct percutaneous coronary interventions offers multiple advantages, the procedure can cause radial artery damage and occlusion. Because radial artery is the preferred site for the creation of an arteriovenous fistula to provide dialysis, patients with chronic kidney disease are particularly dependent on radial artery for their long-term survival. METHODS: In this retrospective study, we investigated the prevalence of chronic kidney disease in patients undergoing coronary interventions via radial artery...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29519382/vascular-access-site-and-outcomes-in-58-870-patients-undergoing-percutaneous-coronary-intervention-with-a-previous-history-of-coronary-bypass-surgery-results-from-the-british-cardiovascular-interventions-society-national-database
#15
Tim Kinnaird, Richard Anderson, Sean Gallagher, James Cockburn, Alex Sirker, Peter Ludman, Mark de Belder, Samuel Copt, James Nolan, Azfar Zaman, Mamas Mamas
OBJECTIVES: Using the British Cardiovascular Intervention Society percutaneous coronary intervention (PCI) database, access site choice and outcomes of patients undergoing PCI with previous coronary artery bypass grafting (CABG) were studied. BACKGROUND: Given the influence of access site on outcomes, use of radial access in PCI-CABG warrants further investigation. METHODS: Data were analyzed from 58,870 PCI-CABG procedures performed between 2005 and 2014...
March 12, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29506964/minimizing-the-risk-of-contrast-induced-nephropathy-and-hemodynamic-collapse-during-chronic-total-occlusion-percutaneous-coronary-intervention-with-a-percutaneous-left-ventricular-assist-device
#16
REVIEW
Damiano Regazzoli, Daisuke Hachinohe, Ozan M Demir, Mauro Carlino, Julien Lemoine, Satoru Mitomo, Enrico Poletti, Max Amor, Antonio Colombo, Lorenzo Azzalini
Candidates for percutaneous coronary revascularization are becoming progressively older and more complex. A combination of factors related to the patient, lesion, and/or hemodynamic conditions may increase the risk of adverse events. Therefore, when a high-risk procedure is identified, it is crucial to provide the patient with adequate support in order to safely perform percutaneous coronary intervention (PCI). We report the case of a 77-year-old man with moderate left ventricular dysfunction and stage IV chronic kidney disease who underwent successful recanalization of a chronically occluded left anterior descending artery...
February 7, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29505003/successful-revascularization-of-noninfarct-related-artery-with-chronic-total-occlusion-among-acute-myocardial-infarction-patients-a-systematic-review-and-meta-analysis
#17
Jiangtao Tong, Qian Yu, Chenggang Li, Xiaojuan Shao, Yong Xia
BACKGROUND: Randomized trials and meta-analyses demonstrated that chronic total occlusion (CTO) in noninfarct related artery (n-IRA) was associated with increased all-cause mortality. Recently, several observational studies suggested that the successful revascularization of n-IRA with CTO decreased all-cause mortality. METHODS: A systematic search was performed in Cochrane Controlled Trials Registry, PubMed, MEDLINE, and EMBASE databases for relevant studies. Article assessing the prognostic role of revascularization of n-IRA with CTO was enrolled in this meta-analysis...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29501432/impact-of-right-atrial-pressure-on-fractional-flow-reserve-calculation-in-the-presence-of-a-chronic-total-occlusion
#18
Grigoris V Karamasis, Andreas S Kalogeropoulos, Shah H Mohdnazri, Firas Al-Janabi, Rohan Jagathesan, Gerald J Clesham, Kare H Tang, Paul A Kelly, John R Davies, Thomas R Keeble
BACKGROUND: The aim of this study was to assess the impact of right atrial pressure (Pra) on non-CTO vessels FFR measurements in patients with a chronic total occlusion. METHODS: Consecutive patients who underwent PCI for a CTO of the right coronary artery (RCA) were included. Prior to RCA recanalization, FFR and FFRmyo were measured in non-CTO vessels. FFR was calculated using the Pd/Pa equation during maximum hyperaemia and also accounting for right atrial pressure (Pd-Pra/Pa-Pra)...
February 7, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29496902/chronic-total-occlusion-percutaneous-coronary-intervention-in-clinical-practice-novel-grounds-to-be-explored
#19
EDITORIAL
Sinisa Stojkovic, Dejan Milasinovic
No abstract text is available yet for this article.
March 1, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29495125/the-impact-of-successful-revascularization-of-coronary-chronic-total-occlusions-on-long-term-clinical-outcomes-in-patients-with-non-st-segment-elevation-myocardial-infarction
#20
Hsin-I Teng, Shih-Hsien Sung, Shao-Sung Huang, Ju-Pin Pan, Shing-Jong Lin, Wan-Leong Chan, Wen-Lieng Lee, Tse-Min Lu, Cheng-Hsueh Wu
OBJECTIVES: The purpose of this study was to assess the long-term clinical impact of revascularization of coronary concomitant coronary chronic total occlusion (CTO) in patients with Non-ST-segment elevation myocardial infarction (NSTEMI). BACKGROUND: CTO is associated with poorer prognosis in patients with NSTEMI. The evidence of revascularization of CTO in patients with NSTEMI is still conflicting. METHODS: Consecutive patients with NSTEMI and CTO who underwent percutaneous coronary intervention (PCI) within 72 h of admission from 2006 to 2015 were retrospectively recruited and analyzed...
March 1, 2018: Journal of Interventional Cardiology
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