scholarly journals Impact of occlusion duration on the success rate and outcomes of percutaneous coronary intervention in chronic total occlusions

2015 ◽  
Vol 23 (3) ◽  
pp. 183-189
Author(s):  
Antonio de Castro Filho ◽  
Edgar Stroppa Lamas ◽  
Mário Barbosa G. Nunes ◽  
Dimytri A. Siqueira ◽  
Rodolfo Staico ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Success Rate ◽  
Coronary Intervention ◽  
Chronic Total Occlusions ◽  
Percutaneous Coronary

scholarly journals Tips and Tricks for PCI of Chronic Total Occlusions – A Review

2021 ◽  
Vol 02 (01) ◽  
pp. 031-041
Author(s):  
Rohit Mody
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Success Rate ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Tips And Tricks ◽  
Total Occlusion ◽  
Chronic Total Occlusions ◽  
Antegrade Approach ◽  
Complex Patients ◽  
Percutaneous Coronary

Chronic total occlusion recanalization still represents the final frontier in percutaneous coronary intervention. Retrograde recanalization is one of the greatest amendments of this technique. At present, it has become an integral complement to the traditional antegrade approach. Despite being most frequently used in complex patients, it has the highest success rate with the lowest incidence of complications. Since its inception, significant iterations have occurred that made this technique safer, faster, and even more successful.

CTO in contemporary PCI

2021 ◽  
Vol 17 ◽  
Author(s):  
Mohamed Farag ◽  
Mohaned Egred
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Success Rate ◽  
Risk Prediction ◽  
Coronary Intervention ◽  
Chronic Total Occlusions ◽  
Percutaneous Coronary ◽  
Increasing Operator ◽  
Scoring Tools ◽  
Insight Into

: Percutaneous coronary intervention (PCI) of chronic total occlusions (CTO) represents the most challenging procedure in modern endovascular treatments. In recent years, the success rate of CTO PCI has substantially improved, owing to increasing operator expertise and advancements in CTO equipment and algorithms as well as the development of expert consensus documents. In this review, we summarize existing evidence for CTO PCI, its success/ risk prediction scoring tools, procedural principles and complications and provide an insight into the future role of CTO PCI.

scholarly journals Reattempt Percutaneous Coronary Intervention of Chronic Total Occlusions after Prior Failures: A Single-Center Analysis of Strategies and Outcomes

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Mingqiang Fu ◽  
Shufu Chang ◽  
Lei Ge ◽  
Dong Huang ◽  
Kang Yao ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Success Rate ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Complication Rates ◽  
Ventricular Ejection Fraction ◽  
Chronic Total Occlusions ◽  
Percutaneous Coronary ◽  
Collateral Channel

Objective. The initial recanalization rate of coronary chronic total occlusions (CTOs) is >85% when performed by experienced operators, but only 10% of prior failed CTO patients receive reattempted recanalization. This retrospective study analyzed the success rate and strategies used in reattempt percutaneous coronary intervention (PCI) of CTOs after prior failures. Methods. Overall, 206 patients with 212 CTOs were enrolled. All patients with prior recanalization failures received reattempt PCIs from January 2015 to March 2019 at Zhongshan Hospital, Fudan University. Data on clinical factors (age, sex, comorbidities, left ventricular ejection fraction, history of cigarette usage, and revascularization), angiographic characteristics of CTOs (target lesion, Japanese Chronic Total Occlusion (J-CTO) score, the morphology of CTO lesions, and collateral channel scale), strategies (procedural approach and use of devices), and major adverse events were obtained and analyzed. Results. The mean age of enrolled patients was 60.96 ± 12.36 years, with a male predominance of 90.3%. Of the patients, 47.1% had a prior myocardial infarction and 70.4% underwent stent implantation previously, while the in-stent occlusion rate was 6.6%. CTOs were primarily localized in the left anterior descending artery (43.9%) and the right coronary artery (43.9%). 80.7% of lesions were classified as very difficult (J-CTO score ≥3), and the overall success rate was 81.1%. In multivariable regression analysis, J-CTO score, collateral channel scale, application of coronary multispiral computed tomography angiography, dual injection, intravascular ultrasound, active greeting technique, parallel wiring, and CTO morphology were predictors of recanalization success. There were no significant differences in rates of procedural complications between the final recanalization success and failure groups. Conclusions. Recanalization of complex CTOs is associated with high success rate and low complication rates when performed by high-volume CTO operators and after multiple reattempts.

scholarly journals The Outcomes of Percutaneous Coronary Intervention in Chronic Total Coronary Occlusion: A Single Center Report

1970 ◽  
Vol 6 (1) ◽  
pp. 13-17
Author(s):  
AKM Fazlur Rahman ◽  
Mohammad Salman ◽  
Sajal K Banerjee ◽  
Khairul Anam ◽  
Mukhlesur Rahman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Success Rate ◽  
Clinical Success ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Chronic Total Occlusions ◽  
Percutaneous Coronary ◽  
Procedural Success

Chronic total occlusions (CTOs) are commonly found on diagnostic angiography, and successful percutaneous coronary intervention leads to an improvement in long-term survival rates. This study was done in the University Cardiac Center, Department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2005 to December 2009. The aim of this study was to examine the trends in angiographic success, clinical success, procedural success and in-hospital outcomes after percutaneous coronary intervention (PCI) for chronic total occlusions (CTO). Total 60 patients (male: female, 11:1) with Mean age 48±10 years were studied. 36 (60%) patients had prior myocardial infarction and all of them had angina (CCS-III, IV). Mean length and reference diameter of the CTO lesion was 19.7±10.4 mm and 2.8±0.5 mm respectably. Clinical success, angiographic success and procedural success rate was (78.3%), (80.0%) and (66.7%) respectably. In hospital adverse outcomes were acute myocardial infarction (5.0%), acute left ventricular failure (6.7%) and malignant arrhythmias (VT, VF) (10.0%). PCI was failed in (11.7%) cases and there was acute in-stent thrombosis in (1.7%) cases. In conclusion it is possible to obtain a relatively high success rate of PCI and favorable clinical outcomes for patients with coronary CTO lesions. Key words: Chronic total occlusions; In hospital adverse outcomes; Percutaneous coronary interventionDOI: 10.3329/uhj.v6i1.7183University Heart Journal Vol.6(1) 2010 pp.13-17

The impact of gender on outcomes in patients with chronic total coronary occlusions undergoing percutaneous coronary intervention: results from a Dutch nationwide registry including 7560 patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Van Veelen ◽  
J Elias ◽  
I.M Van Dongen ◽  
J.P.S Henriques ◽  
P Knaapen
Keyword(s):  
Cardiovascular Disease ◽  
Percutaneous Coronary Intervention ◽  
Survival Curve ◽  
Coronary Intervention ◽  
Chronic Total Occlusions ◽  
Nationwide Registry ◽  
Percutaneous Coronary ◽  
Baseline Characteristics ◽  
Gender Based ◽  
The Impact

Abstract Background Females comprise a minority of patients with chronic total occlusions (CTO). It is known that men have a greater benefit from CTO percutaneous coronary intervention (PCI) than women. We aimed to determine gender-based differences in baseline characteristics and outcomes after PCI in patients with CTO. Methods The Netherlands Heart Registration (NHR) is a nationwide registry that registers outcomes of cardiac interventions. For the purpose of this analysis, the data of all patients undergoing PCI from inception of the NHR to December 2018 were selected, that included PCI with at least one CTO in one of the treated coronary arteries. We compared baseline characteristics and the outcomes 1 year mortality, 30 day myocardial infarction (MI) and target vessel revascularization (TVR) <1 year between men and women. Results A total of 7560 patients were identified that underwent PCI between January 1, 2015 and December 31, 2018 with at least 1 CTO in the treated vessel. A total of 5850 was male (77.4%) and 1710 was female (22.6%). Women were older (68.5±10.6 versus 64.7±10.6 years old, p<0.001), and more frequently had diabetes (29.4% [n=529] versus 25.0% [n=1602], p<0.001) and kidney disease (4.5% [n=529] versus 2.2% [n=142], p<0.001). However, men had more extensive cardiovascular disease, i.e. multi-vessel disease (56.0% [n=3584] versus 50.4% [n=912], p<0.001), previous MI (39.7% [n=2527] versus 31.0% [n=555], p<0.001), previous PCI (48.2% [n=1967] versus 40.2% [n=455], p<0.001) and previous coronary artery bypass grafting (16.8% [n=1085] versus 10.5% [n=191], p<0.001) and more frequently presented with an out-of-hospital cardiac arrest, compared to women (2.1% [n=136] versus 1.1% [n=20], p=0.004). The 1-year mortality was higher in women (10.3% versus 7.5%, p<0.001), as well as the 30-day MI (0.9% versus 0.4%, p=0.043), but men had higher risk for TVR<1 year (11.7% versus 9.5%, p=0.044). Corrected for age and comorbidities, female gender was an independent predictor for mortality (Figure 1; odds ratio 1.83, 95% confidence interval 1.08–3.11, p=0.025). Conclusion In this nationwide registry comprising 7560 CTO patients undergoing PCI, significant gender-based differences were found. Males were found to have more extensive cardiovascular disease. However, females were at higher risk of mortality, possibly due to higher age and higher prevalence of concomitant comorbidities. Figure 1. Survival curve Funding Acknowledgement Type of funding source: None

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