Recanalisation of coronary chronic total occlusions with new techniques including the retrograde approach via collaterals
TLDR
A high degree of success with low in-hospital complications comparable with conventional PCI data can be expected in the hands of experienced CTO operators and a second try with a retrograde approach after antegrade failure should be considered.Abstract:
Objective
Percutaneous treatment of coronary chronic total occlusions (CTO) remains one of the major challenges in interventional cardiology. The strategies of recanalisation in CTO have changed drastically due the development of new techniques such as the retrograde approach via collaterals. In this single-centre experience we sought to analyse the success rates with the use of different CTO techniques, the complication rates, and we evaluated predictors of failed CTO recanalisation attempts.read more
Citations
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Journal ArticleDOI
Subintimal Dissection/Reentry Strategies in Coronary Chronic Total Occlusion Interventions
TL;DR: The chronic total occlusions subintimal dissection/reentry techniques are described in detail, the related terminology is clarified, and the published studies in this area and the current gaps of knowledge are summarized.
Journal Article
The efficacy and safety of the "hybrid" approach to coronary chronic total occlusions: Insights from a contemporary multicenter US registry and comparison with prior studies
Georgios Christopoulos,Rohan V. Menon,Dimitri Karmpaliotis,Khaldoon Alaswad,William Lombardi,Aaron Grantham,Vishal G. Patel,Bavana V. Rangan,Anna Kotsia,Nicholas Lembo,David E. Kandzari,Harold Carlson,Santiago Garcia,Subhash Banerjee,Craig A. Thompson,Emmanouil S. Brilakis +15 more
TL;DR: Use of the hybrid approach to CTO-PCI is associated with higher success and similar complication rates compared to prior studies, supporting its expanded use for treating these challenging lesions.
Journal ArticleDOI
Angiographic success and procedural complications in patients undergoing retrograde percutaneous coronary chronic total occlusion interventions: A weighted meta-analysis of 3482 patients from 26 studies
Abdallah El Sabbagh,Vishal G. Patel,Omar M. Jeroudi,Tesfaldet T. Michael,Mohammed Alomar,Owen Mogabgab,Eric Fuh,Michele Roesle,Bavana V. Rangan,Shuaib M Abdullah,Jeffrey L. Hastings,Jerrold Grodin,Dharam J. Kumbhani,Dimitrios Alexopoulos,Panayotis Fasseas,Subhash Banerjee,Emmanouil S. Brilakis +16 more
TL;DR: Retrograde CTO PCI is associated with high procedural success rate and acceptable risk for procedural complications, and may be associated with an increased risk of major vascular or bleeding events.
Journal ArticleDOI
Clinical Utility of the Japan-Chronic Total Occlusion Score in Coronary Chronic Total Occlusion Interventions: Results from a Multicenter Registry.
Georgios Christopoulos,Michael R. Wyman,Khaldoon Alaswad,Dimitri Karmpaliotis,William Lombardi,J. Aaron Grantham,Robert W. Yeh,Farouc A. Jaffer,Daisha J. Cipher,Bavana V. Rangan,Georgios E. Christakopoulos,Megan A. Kypreos,Nicholas Lembo,David Kandzari,Santiago Garcia,Craig A. Thompson,Subhash Banerjee,Emmanouil S. Brilakis +17 more
TL;DR: J-CTO score was strongly associated with final success and efficiency in this study, supporting its expanded use in CTO interventions.
Journal ArticleDOI
Successful Recanalization of Native Coronary Chronic Total Occlusion Is Not Associated With Improved Long-Term Survival
Pil Hyung Lee,Seung-Whan Lee,Hee-Soon Park,Se Hun Kang,Byeong Joo Bae,Mineok Chang,Jae-Hyung Roh,Sung-Han Yoon,Jung-Min Ahn,Duk-Woo Park,Soo-Jin Kang,Young-Hak Kim,Cheol Whan Lee,Seong-Wook Park,Seung-Jung Park +14 more
TL;DR: It is found that successful CTO-PCI compared with failed PCI was associated with significantly less subsequent coronary artery bypass grafting and this finding was consistent regardless of whether the patient had a multivessel disease including CTO or only had a single CTO disease.
References
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Journal ArticleDOI
Procedural outcomes and long-term survival among patients undergoing percutaneous coronary intervention of a chronic total occlusion in native coronary arteries: a 20-year experience
James A. Suero,Steven P. Marso,Philip G. Jones,Steven B. Laster,Kenneth C. Huber,Lee V. Giorgi,Warren L. Johnson,Barry D. Rutherford +7 more
TL;DR: A successfully revascularized CTO confers a significant 10-year survival advantage compared with failed revascularization and success rates have continued to improve without an accompanying increase in MACE rates.
Journal ArticleDOI
Immediate results and one-year clinical outcome after percutaneous coronary interventions in chronic total occlusions: data from a multicenter, prospective, observational study (TOAST-GISE).
Zoran Olivari,Paolo Rubartelli,Federico Piscione,Federica Ettori,Alessandro Fontanelli,Luigi Salemme,Corinna Giachero,Carlo Di Mario,Gabriele Gabrielli,Leonardo Spedicato,Francesco Bedogni,Toast-Gise Investigators +11 more
TL;DR: At one-year follow-up, patients with successful PCI of a CTO had a significantly better clinical outcome than those whose PCI was unsuccessful, and in a high percentage of CTOs with a low incidence of complications.
Journal ArticleDOI
Stenting in chronic coronary occlusion (SICCO): A randomized, controlled trial of adding stent implantation after successful angioplasty☆
Per Anton Sirnes,Svein Gold,Yngvar Myreng,Per Mølstad,Håkean Emanuelsson,Per Albertsson,Magne Brekke,Arild Mangschau,Knut Endresen,John Kjekshus +9 more
TL;DR: Stent implantation improved long-term angiographic and clinical results after PTCA of chronic coronary occlusions and is thus recommended regardless of the primary PTC a result.
Journal ArticleDOI
Percutaneous coronary intervention for chronic total occlusions: the Thoraxcenter experience 1992-2002.
TL;DR: Successful percutaneous revascularization of a CTO leads to a significantly improved survival rate and a reduction in major adverse events at 5 years, and new technologies must focus on a safe approach to successful recanalization.
Journal ArticleDOI
Trends in outcomes after percutaneous coronary intervention for chronic total occlusions: a 25-year experience from the Mayo Clinic.
Abhiram Prasad,Charanjit S. Rihal,Ryan J. Lennon,Heather J. Wiste,Mandeep Singh,David R. Holmes +5 more
TL;DR: Investigation of trends in procedural success, in-hospital, and long-term outcomes after percutaneous coronary intervention for chronic total occlusions over the last 25 years from a single PCI registry found procedural success rates for CTO have not improved over time in the stent era, highlighting the need to develop new techniques and devices.