0000000000711424
AUTHOR
Carlos M. Campos
Excimer laser atherectomy in an uncrossable long chronic total occlusion through the subintimal space
We present a successfully chronic total occlusions (CTO) coronary recanalisation with the subadventitial space by excimer laser atherectomy (ELCA) adjunctive therapy. Angiogram revealed non-significant diffuse disease of the left coronary system with a complex long proximal right coronary artery (RCA) CTO (J-CTO score 4) and collaterals (Rentrop Grade 2 and Werner classification CC1) from the septal branches (Figure 1, Panel A). CTO PCI of the RCA was then indicated and planned. Initially, antegrade approach and a retrograde approach technique were attempted without success. Thereafter, a rescue Antegrade Dissection Reentry strategy (ADR) was applied. A Pilot 200 (Abbott) was advanced in a …
Risk Burden of Coronary Perforation in Chronic Total Occlusion Recanalization: Latin American CTO Registry Analysis
Background Coronary perforation is a life‐threatening complication of acute percutaneous coronary intervention (PCI) for chronic total occlusions (CTO), but data on midterm outcomes are limited. Methods and Results Data from LATAM (Latin American)‐CTO Registry (57 centers; 9 countries) were analyzed. We assessed the risk of 30‐day, 1‐year major adverse cardiac events of coronary perforation using time‐to‐event and weighted composite end point analysis having CTO PCI without perforation as comparators. Additionally, we studied the independent predictors of perforation in these patients. Of 2054 patients who underwent CTO PCI between 2015 and 2018, the median Multicenter CTO Registry in Japa…
Successful use of impella CP through femoral access in a patient with bilateral iliac and aortic endoprosthesis in the setting of cardiogenic shock
We report the case of a 67-year-old male, with previous history of severe peripheral vascular disease (abdominal aorta aneurism and bilateral iliac stenosis) requiring the implantation of 3 endoprostheses 7 months ago (Figure 1(A)), and previous myocardial infarction 10 years ago. The left ventricular ejection fraction (LVEF) was preserved at last control (58%). The patient was referred for acute coronary syndrome complicated with pulmonary oedema and cardiogenic shock. Echocardiography showed a severe impairment of LVEF (18%) and the patient was transferred to cathlab for emergency percutaneous coronary intervention (PCI). Coronary angiography via right femoral 7Fr access showed a chronic …