scholarly journals Relationship between the triglyceride glucose index and collateral index in patients with coronary chronic total occlusion

2021 ◽  
Vol 8 (3) ◽  
pp. 154-161
Author(s):  
Cihan Aydın
Keyword(s):  
Chronic Total Occlusion ◽  
Total Occlusion ◽  
Triglyceride Glucose Index

scholarly journals High Triglyceride-Glucose Index (TyG) is Associated With Adverse Cardiovascular Events in Patients With Type 2 Diabetes Mellitus (T2DM) and Chronic Total Occlusion (CTO) After Percutaneous Coronary Intervention (PCI)

2021 ◽  
Author(s):  
Xiao Long Lin ◽  
Hao Xuan Sun ◽  
Jin Yang Zhao ◽  
Fan Qi Li ◽  
Dong Hui Zhao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Primary Endpoint ◽  
Cardiovascular Events ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Total Occlusion ◽  
Tyg Index ◽  
Triglyceride Glucose Index ◽  
Percutaneous Coronary

Abstract Background: The triglyceride-glucose index (TyG index) is a reliable surrogate marker of insulin resistance, which is associated with cardiovascular disease morbidity and prognosis. However, the predictive value of the TyG index for cardiovascular events in patients with type 2 diabetes mellitus (T2DM) and chronic total occlusion (CTO) after percutaneous coronary intervention (PCI) has not been specifically studied. Method: The study retrospectively enrolled 687 patients with T2DM and CTO after PCI in the final analysis. Patients were divided into three groups according to the TyG index tertiles. The TyG index was calculated as ln [ fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2 ]. The primary observational endpoint was the composite of overall death, non-fatal stroke, non-fatal myocardial infarction (MI), or unplanned revascularization.Results: During a median follow-up of 22.0 months, 159 patients (23.14%) experienced primary endpoint events. Multivariate Cox hazards regression analysis showed that the TyG index was significantly correlated with the primary endpoint [HR 2.827, 95% CI (1.877-4.529), P＜0.001]. Kaplan–Meier curves for the primary endpoint showed a significant difference between the lower and higher TyG index group was mainly driven by the increased incidence of unplanned revascularization (Log-rank P＜0.001).Conclusion: The TyG index may be a remarkable predictor of adverse cardiovascular events, especially unplanned revascularization in patients with T2DM and CTO who are treated by PCI.

Primary Stenting for Chronic Total Occlusion of the Infrarenal Aorta

2000 ◽  
Vol 7 (4) ◽  
pp. 340-344 ◽  
Author(s):  
Christos D. Karkos ◽  
Stephen P. D'Souza ◽  
Robert Hughes
Keyword(s):  
Chronic Total Occlusion ◽  
Infrarenal Aorta ◽  
Total Occlusion ◽  
Primary Stenting

scholarly journals Successful case of direct puncture of a prosthetic bypass graft in endovascular treatment for long superficial artery chronic total occlusion: a case report

2020 ◽  
Author(s):  
Makoto Sugihara ◽  
Yoko Ueda ◽  
Yuiko Yano ◽  
Shin-Ichiro Miura
Keyword(s):  
Femoral Artery ◽  
Chronic Total Occlusion ◽  
Bypass Graft ◽  
Common Femoral Artery ◽  
Critical Limb Ischaemia ◽  
Complete Revascularization ◽  
Anastomotic Site ◽  
Graft Occlusion ◽  
Total Occlusion ◽  
Direct Puncture

Abstract Background The access site for endovascular therapy (EVT) is often limited because of multi-vascular diseases. Prior lower limb bypass can potentially limit the availability of common femoral artery access when EVT is required. Case summary An 88-year-old woman who presented with non-healing ulceration in the dorsalis pedis of the left foot despite treatment for several months was admitted to our hospital. She had undergone axillo-bilateral femoral bypass surgery for right critical limb ischaemia 3 years previously. Ultrasound and contrast computed tomography demonstrated bypass graft occlusion, left superficial femoral artery (SFA)-popliteal artery long chronic total occlusion from the origin with severe calcification and severe stenosis in the bilateral common femoral artery close to the anastomotic site. EVT for the left SFA occlusion was necessary to save the left foot, but access sites for EVT were limited. We decided to puncture an occluded axillo-femoral prosthetic bypass graft. It is difficult to cross the wire with only an antegrade approach. Therefore, it was necessary to use a bi-directional approach with dorsalis pedis artery puncture and the Rendez-vous technique. Finally, angiogram demonstrated improved blood flow to the wound site, and haemostasis at the puncture site could be achieved by manual compression. The ulceration healed within a month. Discussion Direct puncture of a prosthetic bypass graft and additional techniques resulted in complete revascularization. Thus, direct puncture of a bypass graft could be a useful EVT strategy for patients with complex and extremely long chronic total occlusion.

Endothelial avulsion of the septal branch during retrograde chronic total occlusion intervention

2021 ◽  
Author(s):  
Hicham El Jattari ◽  
Carlo Zivelonghi ◽  
Benjamin Scott ◽  
Mick Luykx ◽  
Pierfrancesco Agostoni
Keyword(s):  
Chronic Total Occlusion ◽  
Total Occlusion ◽  
Septal Branch

scholarly journals Late survival benefit of percutaneous coronary intervention compared with medical therapy in patients with coronary chronic total occlusion: a 10-year follow-up study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T.K Park ◽  
S.H Choi ◽  
J.M Lee ◽  
J.H Yang ◽  
Y.B Song ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Treatment Strategy ◽  
Initial Treatment ◽  
Cardiac Death ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Total Occlusion ◽  
Percutaneous Coronary

Abstract Background As an initial treatment strategy, percutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) did not show mid-term survival benefits compared with optimal medical therapy (OMT). Purpose To compare 10-year clinical outcomes between OMT and PCI in CTO patients. Methods Between March 2003 and February 2012, 2,024 patients with CTO were enrolled in a single center registry and followed for about 10 years. We excluded CTO patients who underwent coronary artery bypass grafting, and classified patients into the OMT group (n=664) or PCI group (n=883) according to initial treatment strategy. Propensity-score matching was performed to minimize potential selection bias. The primary outcome was cardiac death. Results In the PCI group, 699 patients (79.2%) underwent successful revascularization. Clinical and angiographic characteristics revealed more comorbidities and more complex lesions in the OMT group than in the PCI group. At 10 years, the PCI group had lower risks of cardiac death (10.4% versus 22.3%; HR 0.43; 95% CI 0.32 to 0.57; p<0.001) than the OMT group. After the propensity-score matching analyses, the PCI group had lower risks of cardiac death (13.6% versus 20.8%; HR 0.62; 95% CI 0.44 to 0.88; p=0.007), acute myocardial infarction (6.3% versus 11.2%; HR 0.55; 95% CI 0.34 to 0.91; p=0.02), any revascularization (23.9% versus 32.2%; HR 0.67; 95% CI 0.51 to 0.88; p=0.004) than the OMT group. The beneficial effects of CTO PCI were consistent across various subgroups (all p-values for interaction: non-significant). Conclusions As an initial treatment strategy, PCI reduced late cardiac death compared with OMT in CTO patients. Cardiac death in matched population Funding Acknowledgement Type of funding source: None

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