Intravascular Imaging for Chronic Total Occlusion Intervention

Xenogiannis, Iosif; Tajti, Péter; Karmpaliotis, Dimitri; Garbo, Roberto; Gagnor, Andrea; Burke, M. Nicholas; Brilakis, Emmanouil S.

doi:10.1007/s12410-018-9471-3

Cited by 10 publications

(8 citation statements)

References 46 publications

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“…If the wire has failed to cross the CTO and reached a subintimal position distal to the occlusion, antegrade injections must be strictly avoided. An IVUS probe can follow the wire and help direct a second wire to a different track starting from the proximal stump, offering real-time confirmation of its position in the distal true lumen 167,168 .…”

Section: Ivus-guided Re-entrymentioning

confidence: 99%

Recanalisation of coronary chronic total occlusions

Mario¹,

Mashayekhi²,

Garbo³

et al. 2022

EuroIntervention

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Percutaneous treatment of coronary chronic total occlusions (CTO) has advanced greatly since its advent in the late 1970s through the development of dedicated wires and microcatheters, the improved skills of highly experienced operators and the adoption of new sophisticated strategies to guide procedural planning. The contemporary procedural success rate is 80-90% with a reduction in complications. Although there has been no improvement in prognosis in randomised trials to date, they, and other controlled registries of thousands of patients, confirm the pivotal role of CTO recanalisation in the treatment of angina and dyspnoea and an improvement in quality of life. Despite this evidence, CTO recanalisation is grossly underutilised. This review reports a detailed overview of the history, indications and treatment strategies for CTO recanalisation and hopes to increase interest among new, and especially young, operators in this demanding, rapidly evolving field of interventional cardiology.

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Section: Ivus-guided Re-entrymentioning

confidence: 99%

Recanalisation of coronary chronic total occlusions

Mario¹,

Mashayekhi²,

Garbo³

et al. 2022

EuroIntervention

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“…The recanalization rate has been improved to 85-90% in most experience centers using new algorithms with guidewire escalation, including the use of intravascular ultrasound (IVUS). Additionally, the safety of this procedure has also recently improved, with intraprocedure complications occurring in less than 3% of cases [7,8].…”

Section: Pci For Cto-an Overviewmentioning

confidence: 99%

“…2B) [22]. Furthermore, as mention above, intravascular imaging especially IVUS can act as adjuvant to recanalization of CTOs, but also (IVUS and OCT) as a tool to determine if the small caliber of the distal epicardial coronary is due to hypoperfusion versus dissection versus atherosclerosis and find the real vessel diameter, lesion length and plaque characteristics in order to select the best DCB or stent [7].…”

Section: Clinical Stand Point Of Dcb Use For Cto Interventionmentioning

confidence: 99%

Drug-coated balloon for the management of coronary chronic total occlusions

Sanchez-Jimenez¹,

El-Mokdad²,

Chaddad³

et al. 2022

Rev. Cardiovasc. Med.

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There is a higher rate of successful recanalization of patients with coronary chronic total occlusions, nevertheless, the rate of patients referred for revascularization remains low. In addition, there is a greater need to improve long-term outcomes of chronic total occlusions after percutaneous coronary intervention, and although the implantation of new-generation drug-eluting stents has been optimized with coronary imaging guidance, the rate of stenting failure remains a major issue and long-term vessel patency could be improved. We reviewed clinical data regarding the benefit of treating chronic total occlusions and the use of drug-coated balloons as an alternative therapeutic modality in this setting. Although clinical data is limited, the initial evidence and the daily clinical practice point towards a synergistic hybrid treatment strategy based on the combination of drug-coated balloons plus drug-eluting stents, reducing the total stent length and maintaining the scaffolding properties of stents where it is mandatory. Additionally, drug-coated balloons allow natural enlargement of the open vessel after percutaneous coronary intervention (PCI), which is a major limitation of stents in chronic total occlusion (CTO).

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“…It also talks about the calci ication of the plaque. But to visualize the plaque the anatomic arrangement should be precise [25].…”

Section: Ivus Guided Wiring Technique Involves I) Side Branch Ivus Guidedmentioning

confidence: 99%

“…Another point is contrasted injection is should be given very cautiously so that to avoid hydraulic dissections in the subintimal space. Multiple stents will be required to cover the whole subintimal space [25].…”

Section: Ivus Guided Wiring Technique Involves I) Side Branch Ivus Guidedmentioning

confidence: 99%

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

Rohit¹

2021

RIJCCM

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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.

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Intravascular Imaging for Chronic Total Occlusion Intervention

Cited by 10 publications

References 46 publications

Recanalisation of coronary chronic total occlusions

Recanalisation of coronary chronic total occlusions

Drug-coated balloon for the management of coronary chronic total occlusions

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

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