0000000000157206
AUTHOR
Luca Costanzo
Highlights and essentials from the first "experts-live" course of the EuroCTO club
Chronic total occlusions (CTOs) are frequently encountered during diagnostic coronary catheterisation. However, there is still confusion regarding the indication for percutaneous coronary intervention (PCI) in this lesion subset, mainly because it is cumbersome and the prognostic impact of revascularisation in these patients remains unclear. Many studies have now shown the long term clinical benefits after CTO PCI1-3; still, with procedural complexity, high radiation exposure to both the patient and the operator, high costs and lower procedural success rates, most patients with CTO are managed medically or referred for bypass graft surgery – regardless of the severity of symptoms and extent…
Recanalization of complex coronary chronic total occlusions using high-frequency vibrational energy CROSSER catheter as first-line therapy: A single center experience
Background: Several studies have illustrated the safety and the procedural outcome of high-frequency vibrational energy in guidewire refractory chronic total occlusions (CTOs). Aim: To evaluate the advantage of high-frequency vibrational energy device (CROSSER Catheter) use in coronary complex CTO revascularization as primary strategy. Methods: CROSSER was used as a primary approach if four or more unfavorable angiographic features were observed in the CTO lesions. Results: From May 2007 to February 2009, a CTO percutaneous intervention attempt was performed in 178 lesions of 171 patients (60.1 ± 8.9 age with 49.4 ± 7.2% in ejection fraction). Among these, the CROSSER was used in 46 complex…
Retrograde recanalization of an in-stent ostial chronically occluded right coronary artery
We describe a case of a chronic proximal in-stent CTO extending up to the ostium of a right coronary artery where successful achievement of guidewire passage through the CTO was performed with a retrograde approach. Guidewire trapping into the right guiding catheter was performed thereafter and procedure was completed by retrograde balloon crossing and antegrade stenting. © 2009 Elsevier Ireland Ltd.
Prognostic value of exercise myocardial scintigraphy in patients with coronary chronic total occlusions.
Objectives: To evaluate the prognostic value of exercise myocardial scintigraphy in patients undergoing incomplete revascularization by means of percutaneous coronary intervention (PCI) with at least a residual chronic total occlusion (CTO) left untreated. Methods: Of 569 consecutive patients with multivessel disease undergoing myocardial scintigraphy after incomplete revascularization by PCI between March 1997 and December 2004, 126 (79% male, 64 ± 10 years) with ≥ 1 residual CTO fulfilled the eligibility criteria and entered in the study. Hard events defined as cardiac death and myocardial infarction, soft events defined as incidence of unstable angina and PCI procedures, and their compos…