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Chronic total occlusion coronary

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https://www.readbyqxmd.com/read/28716335/management-of-chronic-total-coronary-occlusion-in-stable-ischemic-heart-disease-by-percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-versus-medical-therapy
#1
Mony Shuvy, Feng Qiu, Alyssandra Chee-A-Tow, John J Graham, Wael Abuzeid, Christopher Buller, Bradley H Strauss, Harindra C Wijeysundera
Coronary chronic total occlusions (CTOs) are found in approximately 20% of angiograms. We sought to assess the variation in the management of patients with CTOs and to compare the clinical outcomes of CTO lesions with those of non-CTO lesions. We conducted a population-based cohort study and included all patients with stable angina who underwent cardiac catheterization from October 1, 2012, to June 30, 2013, in Ontario, Canada. The primary outcome was a composite of mortality and hospitalization for myocardial infarction...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28707316/ticagrelor-and-absorb-bioresorbable-vascular-scaffold-implantation-for-recovery-of-vascular-function-after-successful-chronic-total-occlusion-recanalization-tiger-bvs-trial-rationale-and-study-design
#2
Salvatore Brugaletta, Josep Gomez-Lara, Juan Caballero, Luis Ortega-Paz, Luis Teruel, Miriam Jimenez Fernandez, Rafael Romaguera, Vicente Alcalde Martinez, Marcos Ñato, Eduardo Molina Navarro, Joan-Antoni Gomez-Hospital, Concepcion Correa Vilches, Maria Joyera, Angel Cequier, Manel Sabate
OBJECTIVES: To explore the role of ticagrelor versus clopidogrel in coronary blood flow normalization immediately after chronic coronary total occlusion (CTO) recanalization. BACKGROUND: Coronary vascular function of a CTO immediately after recanalization is demonstrated to be poor. METHODS: The TIGER BVS is a prospective, double-randomized, open-label, two parallel-group controlled clinical trial to evaluate efficacy of ticagrelor versus clopidogrel in improving vascular function of coronary segment distal to CTO immediately after CTO recanalization...
July 14, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28705045/percutaneous-coronary-interventions-of-chronic-total-occlusions-a-review-of-clinical-indications-treatment-strategy-and-current-practice
#3
Johan Bennett, Peter Kayaert, Yoann Bataille, Jo Dens
Chronic total occlusions (CTOs) are commonly encountered in patients undergoing coronary angiography, but percutaneous coronary intervention (PCI) for CTO is currently infrequently performed owing to the perception of limited clinical benefit, high complexity and cost of intervention, and perceived risk of complications. Numerous observational studies have demonstrated that successful CTO revascularization is associated with better cardiovascular outcomes and enhanced quality of life (QOL). However, in the absence of randomized trials, its prognostic benefit remains debated...
July 14, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28692460/coronary-intervention-for-chronic-total-occlusion-current-indications-and-future-directions
#4
Janarthanan Sathananthan, Vladimír Džavík
Chronic total occlusions (CTOs) are routinely encountered during coronary angiography, but subsequent revascularization rates are low. This has likely been driven by a historical belief that there is minimal clinical benefit and poor success rates with a percutaneous coronary intervention (PCI). However, in the current era, with the development of new techniques and tools, experienced operators can perform CTO-PCI successfully in the majority of patients. The current indications and benefit of CTO-PCI remain a topic of controversy and debate...
August 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28692458/angiographic-and-clinical-outcomes-after-recanalization-of-coronary-chronic-total-occlusions-with-the-orsiro-sirolimus-eluting-stent-compared-with-the-resolute-zotarolimus-eluting-stent
#5
Sinisa Markovic, Michael Lützner, Sergiu Dragomir, Wolfgang Rottbauer, Jochen Wöhrle
OBJECTIVE: The third generation drug eluting Orsiro stent had shown already promising results in non-complex lesions. BACKGROUND: We evaluated angiographic and 24 month clinical results of the sirolimus eluting Orsiro stents (O-SES) after recanalization of coronary chronic total occlusions (CTO). Results were compared with the zotarolimus eluting Resolute Integrity (R-ZES). METHODS: In a prospective series 57 patients were treated with a R-ZES followed by 74 patients treated with a O-SES stent...
August 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28690297/successful-complete-revascularization-with-pci-using-super-low-volume-of-contrast-medium-in-a-patient-with-three-vessel-disease-including-2-chronic-total-occlusions-with-severe-renal-dysfunction
#6
Masahiro Koide, Masayuki Kato, Kimihito Usui, Kayoko Mera, Yoshinori Tsubakimoto, Koji Isodono, Tomohiko Sakatani, Akiko Matsuo, Keiji Inoue, Hiroshi Fujita
The most important factor for preventing contrast-induced nephropathy (CIN) during percutaneous coronary intervention (PCI) in patients with severe renal dysfunction is to minimize the contrast volume. Herein, we report a successful case of complete revascularization after 3 separate PCI procedures using a super-low volume of contrast medium in a patient with 3-vessel disease, including two chronic total occlusions (CTOs). A 70-year-old man having exertional angina despite maximal medical therapy was referred to our hospital...
July 10, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28683937/demonstration-of-the-safety-and-feasibility-of-robotically-assisted-percutaneous-coronary-intervention-in%C3%A2-complex-coronary-lesions-results-of-the-cora-pci-study-complex-robotically-assisted%C3%A2-percutaneous-coronary-intervention
#7
Ehtisham Mahmud, Jesse Naghi, Lawrence Ang, Jonathan Harrison, Omid Behnamfar, Ali Pourdjabbar, Ryan Reeves, Mitul Patel
OBJECTIVES: The aims of this study were to evaluate the feasibility and technical success of robotically assisted percutaneous coronary intervention (R-PCI) for the treatment of coronary artery disease (CAD) in clinical practice, especially in complex lesions, and to determine the safety and clinical success of R-PCI compared with manual percutaneous coronary intervention (M-PCI). BACKGROUND: R-PCI is safe and feasible for simple coronary lesions. The utility of R-PCI for complex coronary lesions is unknown...
July 10, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28675508/chronic-total-occlusion-in-an-infarct-related-coronary-artery-and-the-risk-of-appropriate-icd-therapies
#8
Andrea Di Marco, Ignasi Anguera, Luis Teruel, Guillem Muntane, Niall G Campbell, David J Fox, Benjamin Brown, Chris Skene, Neil Davidson, Valentina Leon, Paolo Dallaglio, Hind Elzein, Elena Garcia-Romero, Joan Antoni Gomez-Hospital, Angel Cequier
INTRODUCTION: Risk stratification for ventricular arrhythmias in patients with ischemic cardiomyopathy needs to be improved. Coronary chronic total occlusions in an infarct-related artery (IRA-CTOs) have been associated with an increased arrhythmic risk. This study aimed to evaluate the association between IRA-CTOs and appropriate implantable cardioverter-defibrillator (ICD) therapies. METHODS AND RESULTS: Observational cohort study that included 342 patients with ischemic cardiomyopathy, an ICD implanted for primary or secondary prevention and a coronary angiography performed shortly before ICD implantation...
July 4, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28668311/full-metal-jacket-with-drug-eluting-stents-for-coronary-chronic-total-occlusion
#9
Pil Hyung Lee, Seung-Whan Lee, Sung-Cheol Yun, Jaeseok Bae, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
OBJECTIVES: The aim of this study was to evaluate the long-term outcomes and predictors of adverse events following successful "full metal jacket" (FMJ) (stent length ≥60 mm without gap) procedures using drug-eluting stents to treat coronary chronic total occlusions (CTOs). BACKGROUND: The FMJ stenting procedure is often required to treat CTOs, but its clinical efficacy and safety remain unknown. METHODS: In total, 1,126 successful CTO procedures (1,107 consecutive patients) performed between May 2003 and March 2015 were studied...
June 21, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28667810/coronary-artery-aneurysm-after-mini-crush-drug-eluting-stent-technique-in-a-chronic-total-occlusion
#10
Alfonso Jurado-Román, María T López-Lluva, Ignacio Sánchez-Pérez, Fernando Lozano Ruíz-Poveda
A 53-year-old man underwent percutaneous coronary intervention of a chronic total occlusion of the circumflex artery. A mini-crush stent technique with two drug-eluting stents was performed. To the best of our knowledge, this is the first case of coronary artery aneurysm affecting a bifurcated chronic total occlusion treated with a two-stent technique.
July 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28652627/-percutaneous-treatment-of-coronary-chronic-total-occlusions-state-of-the-art
#11
Alessio Mattesini, Serafina Valente, Carlotta Sorini Dini, Simone Bartolini, Gianluca Caiazzo, Giorgio Baldereschi, Alfredo Galassi, Carlo Di Mario
Successful percutaneous coronary intervention of chronic total occlusions (CTO) is associated with favorable clinical outcomes in selected subsets of patients. The success rate of CTO interventions greatly increased over the last decades, thanks to the development of dedicated materials and interventional strategies. Nevertheless, CTO interventions are still challenging with higher complication rates and lower success rates compared to standard percutaneous coronary interventions. Dedicated CTO operators are warranted in order to minimize the rate of complications and to achieve a success rate near to 90%...
June 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28648437/utility-of-adjunctive-modalities-in-coronary-chronic-total-occlusion-intervention
#12
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
#13
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/28624405/coronary-computed-tomographic-angiography-can-predict-chronic-total%C3%A2-occlusion-recanalization-success-where-do-we-go-from-here
#14
EDITORIAL
Stephan Achenbach, Monique Tröbs
No abstract text is available yet for this article.
June 9, 2017: JACC. Cardiovascular Imaging
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
#15
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 14, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28616560/successful-revascularization-improves-long-term-clinical-outcome-in-patients-with-chronic-coronary-total-occlusion
#16
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/28615235/percutaneous-revascularization-of-chronic-total-coronary-occlusion-for-whom
#17
Andrew Kei-Yan Ng, Pinak Bipin Shah, David O Williams
No abstract text is available yet for this article.
June 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28612905/treatment-of-coronary-chronic-total-occlusion-by-transradial-approach-current-trends-and-expert-recommendations
#18
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/28610693/assessment-of-peak-skin-dose-in-interventional-cardiology-a-comparison-between-gafchromic-film-and-dosimetric-software-em-dose
#19
J Greffier, C Van Ngoc Ty, G Bonniaud, G Moliner, B Ledermann, L Schmutz, L Cornillet, G Cayla, J P Beregi, F Pereira
OBJECTIVE: To compare the use of a dose mapping software to Gafchromic film measurement for a simplified peak skin dose (PSD) estimation in interventional cardiology procedure. METHODS: The study was conducted on a total of 40 cardiac procedures (20 complex coronary angioplasty of chronic total occlusion (CTO) and 20 coronary angiography and coronary angioplasty (CA-PTCA)) conducted between January 2014 to December 2015. PSD measurement (PSDFilm) was obtained by placing XR-RV3 Gafchromic under the patient's back for each procedure...
June 2017: Physica Medica: PM
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
#20
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
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