Dual catheter technique for the treatment of severe coronary artery perforations

Ben‐Gal, Yanai; Weisz, Giora; Collins, Michael B.; Généreux, Philippe; Dangas, George; Teirstein, Paul S.; Singh, Varinder; Rabbani, Le Roy E.; Kodali, Susheel; Sherman, Warren; Leon, Martin B.; Moses, Jeffrey W.

doi:10.1002/ccd.22331

Cited by 80 publications

(37 citation statements)

References 37 publications

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“…Safety devices: CTO PCI catheterization laboratories should be equipped with a selection of covered stents (25), embolization coils and delivery systems, pericardiocentesis trays to manage perforation (26), and thrombectomy devices to manage thrombotic complications. Hemodynamic support system availability is a prerequisite as well.…”

Section: Device Platforms To Support Cto Pcimentioning

confidence: 99%

A Percutaneous Treatment Algorithm for Crossing Coronary Chronic Total Occlusions

Brilakis¹,

Grantham²,

Rinfret³

et al. 2012

JACC: Cardiovascular Interventions

544

362

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Coronary chronic total occlusions (CTOs) are frequently identified during coronary angiography and remain the most challenging lesion group to treat. Patients with CTOs are frequently left unrevascularized due to perceptions of high failure rates and technical complexity even if they have symptoms of coronary disease or ischemia. In this review, the authors describe a North American contemporary approach for percutaneous coronary interventions for CTO. Two guide catheters are placed to facilitate seamless transition between antegrade wire-based, antegrade dissection re-entry-based, and retrograde (wire or dissection re-entry) techniques, the "hybrid" interventional strategy. After dual coronary injection is performed, 4 angiographic parameters are assessed: 1) clear understanding of location of the proximal cap using angiography or intravascular ultrasonography; 2) lesion length; 3) presence of branches, as well as size and quality of the target vessel at the distal cap; and 4) suitability of collaterals for retrograde techniques. On the basis of these 4 characteristics, an initial strategy and rank order hierarchy for technical approaches is established. Radiation exposure, contrast utilization, and procedure time are monitored throughout the procedure, and thresholds are established for intraprocedural strategy conversion to maximize safety, efficiency, and effectiveness.

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Section: Device Platforms To Support Cto Pcimentioning

confidence: 99%

A Percutaneous Treatment Algorithm for Crossing Coronary Chronic Total Occlusions

Brilakis¹,

Grantham²,

Rinfret³

et al. 2012

JACC: Cardiovascular Interventions

544

362

View full text Add to dashboard Cite

show abstract

“…The largest published series describes 124 events, and the total literature is <1000 cases. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Given the small numbers of events per published series, it has not been possible to examine several key questions relating to the occurrence and outcomes of CP. First, it is unclear from the available evidence what the true incidence of CP is and whether its incidence increasing or decreasing.…”

mentioning

confidence: 99%

Incidence, Determinants, and Outcomes of Coronary Perforation During Percutaneous Coronary Intervention in the United Kingdom Between 2006 and 2013

Kinnaird

Kwok

Kontopantelis

et al. 2016

Circ: Cardiovascular Interventions

105

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Background-As coronary perforation (CP) is a rare but serious complication of percutaneous coronary intervention (PCI) the current evidence base is limited to small series. Using a national PCI database, the incidence, predictors, and outcomes of CP as a complication of PCI were defined. Adjusted odds of adverse outcomes were higher in patients with CP for all major adverse coronary events, including stroke, bleeding, and mortality. Emergency surgery was required in 3% of cases. Predictors of mortality in patients with CP included age, diabetes mellitus, previous myocardial infarction, renal disease, ventilatory support, use of circulatory support, glycoprotein inhibitor use, and stent type. Conclusions-Using a national PCI database for the first time, the incidence, predictors, and outcomes of CP were defined. Methods and Results-DataAlthough CP as a complication of PCI occurred rarely, it was strongly associated with poor outcomes. (Circ Cardiovasc Interv. 2016;9:e003449.

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“…Essa técnica foi descrita pela primeira vez por Silver et al 6 para o tratamento de PC tipo III, selada com stent recoberto com PTFE, que foi liberado por meio de um segundo cateter-guia inserido na artéria femoral contralateral, enquanto o local da perfuração era controlado e selado com o balão de angioplastia. Ben-Gal et al 5 descreveram recentemente a primeira série de doentes tratados pela técnica de duplo cateter. O número de pacientes incluídos nesse estudo não foi suficientemente adequado para gerar conclusões definitivas, mas a observação de taxa relativamente mais baixa de eventos adversos utilizando a técnica de duplo cateter-guia parece favorecer essa abordagem.…”

Section: Discussionunclassified

Tratamento com a técnica de duplo cateter-guia de perfuração coronária tipo III

Martins-Filho¹,

Borghi²,

Puzzi³

et al. 2013

Rev. Bras. Cardiol. Invasiva

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Dual catheter technique for the treatment of severe coronary artery perforations

Abstract: The dual catheter technique is a relatively safe and reproducible approach to treat a PCI induced severe coronary artery perforation, and may improve outcome compared to historical series.

Cited by 80 publications

References 37 publications

A Percutaneous Treatment Algorithm for Crossing Coronary Chronic Total Occlusions

A Percutaneous Treatment Algorithm for Crossing Coronary Chronic Total Occlusions

Incidence, Determinants, and Outcomes of Coronary Perforation During Percutaneous Coronary Intervention in the United Kingdom Between 2006 and 2013

Tratamento com a técnica de duplo cateter-guia de perfuração coronária tipo III

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