Search results for "Total occlusion"
showing 10 items of 41 documents
Derivation and Validation of a Chronic Total Coronary Occlusion Intervention Procedural Success Score From the 20,000-Patient EuroCTO Registry : the …
2019
Objectives: The aim was to establish a contemporary scoring system to predict the outcome of chronic total occlusion coronary angioplasty. Background: Interventional treatment of chronic total coronary occlusions (CTOs) is a developing subspecialty. Predictors of technical success or failure have been derived from datasets of modest size. A robust scoring tool could facilitate case selection and inform decision making. Methods: The study analyzed data from the EuroCTO registry. This prospective database was set up in 2008 and includes >20,000 cases submitted by CTO expert operators (>50 cases/year). Derivation (n = 14,882) and validation (n = 5,745) datasets were created to develop a …
Total occlusion of aortic arch in a 62-year-old man presenting with acute myocardial infarction
2011
Not available
Excimer laser atherectomy in an uncrossable long chronic total occlusion through the subintimal space
2020
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 …
Recanalization of Totally Occluded Coronary Vessels by Percutaneous Transluminal Coronary Angioplasty
1986
Since its introduction in 1977, percutaneous transluminal coronary angioplasty (PTCA) has become an effective approach for treatment of patients with single-vessel disease [1–3, 5]. Treatment of double- and multiple-vessel disease has also been attempted [5, 6]. In patients with angina pectoris total occlusion of coronary vessels is found, and PTCA has also been used in an attempt to restore coronary blood flow in such patients [8, 10]. Even main stem occlusions have been recanalized [11]. In patients with total occlusion of coronary vessels, collateral flow is sufficient to maintain cardiac function at rest but not during exercise [12–14]. Therefore, PTCA seems to be an ideal method for re…
Channel Tracking Guidewire and Technique for Retrograde Approach
2020
Evaluation of the collateral circulation is critical for determining the feasibility of the retrograde approach. When assessing collateral channels it is of paramount importance to take time and review the previous angiogram carefully, for multiple potential collateral pathways, as the predominant collateral may change over time prior to the procedure. Careful review of collaterals prior to the procedure can reduce contrast and radiation dose as well as the duration of the procedure.Retrograde access to the distal vessel can be achieved via septal collaterals, epicardial collaterals (atrial channel), or (patent or occluded) coronary bypass grafts. Generally septals are used more often 65–70…
Global Chronic Total Occlusion Crossing Algorithm: JACC State-of-the-Art Review
2021
© 2021 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC-BY-NC-ND license.
Choice of CTO scores to predict procedural success in clinical practice. A comparison of 4 different CTO PCI scores in a comprehensive national regis…
2021
Background We aimed to compare the performance of the recent CASTLE score to J-CTO, CL and PROGRESS CTO scores in a comprehensive database of percutaneous coronary intervention of chronic total occlusion procedures. Methods Scores were calculated using raw data from 1,342 chronic total occlusion procedures included in REBECO Registry that includes learning and expert operators. Calibration, discrimination and reclassification were evaluated and compared. Results Mean score values were: CASTLE 1.60±1.10, J-CTO 2.15±1.24, PROGRESS 1.68±0.94 and CL 2.52±1.52 points. The overall percutaneous coronary intervention success rate was 77.8%. Calibration was good for CASTLE and CL, but not for J-CTO…
Randomized controlled comparison of optimal medical therapy with percutaneous recanalization of chronic total occlusion (COMET-CTO)
2021
The aim of this randomized prospective study was to evaluate the quality of life (QoL) using the “Seattle Angina Questionnaire” (SAQ) in patients with chronic total occlusion (CTO) in coronary arteries treated with either percutaneous coronary intervention (PCI) or optimal medical therapy (OMT), or only with OMT. The potential benefits of recanalization of CTO by PCI have been controversial because of the scarcity of randomized controlled trials. A total of 100 patients with CTO were randomized (1:1) prospectively into the PCI CTO or the OMT group (50 patients in each group). There were no baseline differences in the SAQ scores between the groups, except for physical limitation scores (P = …
Procedural, Functional and Prognostic Outcomes Following Recanalization of Coronary Chronic Total Occlusions. Results of the Iberian Registry.
2019
Introduction and objectives: There is current controversy regarding the benefits of percutaneous recanalization (PCI) of chronic total coronary occlusions (CTO). Our aim was to determine acute and follow-up outcomes in our setting. Methods: Two-year prospective registry of consecutive patients undergoing PCI of CTO in 24 centers. Results: A total of 1000 PCIs of CTO were performed in 952 patients. Most were symptomatic (81.5%), with chronic ischemic heart disease (59.2%). Previous recanalization attempts had been made in 15%. The mean SYNTAX score was 19.5 +/- 10.6 and J-score was > 2 in 17.3%. A retrograde procedure was performed in 92 patients (9.2%). The success rate was 74.9% and was hi…
Retrograde Recanalization of Chronic Total Occlusions in Europe: Procedural, In-Hospital, and Long-Term Outcomes From the Multicenter ERCTO Registry.
2015
BACKGROUND A retrograde approach improves the success rate of percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs). OBJECTIVES The authors describe the European experience with and outcomes of retrograde PCI revascularization for coronary CTOs. METHODS Follow-up data were collected from 1,395 patients with 1,582 CTO lesions enrolled between January 2008 and December 2012 for retrograde CTO PCI at 44 European centers. Major adverse cardiac and cerebrovascular events were defined as the composite of cardiac death, myocardial infarction, stroke, and further revascularization. RESULTS The mean patient age was 62.0 +/- 10.4 years; 88.5% were men. Procedural and clinical…