Percutaneous transluminal coronary angioplasty of chronic total occlusions. determinants of primary success and long-term clinical outcome

Noguchi, Teruo; Miyazaki, Shunichi; Morii, Isao; Daikoku, Satoshi; Goto, Yoichi; Nonogi, Hiroshi

doi:10.1002/(sici)1522-726x(200003)49:3<258::aid-ccd7>3.0.co;2-l

Cited by 211 publications

(158 citation statements)

References 20 publications

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“…Mollet et al also reported that CTO lesion length > 15 mm measured on CT was associated with higher failure rate of PCI . Heavy calcification of CTO has been reported to be an independent predictor of failed PCI of CTO (Noguchi et al, 2000). The exact location of calcified plaque on the image of coronary CT angiography may help the interventionist to steer the guide wire away from the calcified lesion that is not well seen on conventional angiography.…”

Section: Total Occlusionsmentioning

confidence: 99%

Image Post-Processing and Interpretation

Jinzaki¹,

Yamada²,

Kuribayashi³

2011

Advances in the Diagnosis of Coronary Atherosclerosis

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Section: Total Occlusionsmentioning

confidence: 99%

Image Post-Processing and Interpretation

Jinzaki¹,

Yamada²,

Kuribayashi³

2011

Advances in the Diagnosis of Coronary Atherosclerosis

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“…High procedural success rates in conjunction with low complication rates improve risk/beneit ratio and are paramount for the acceptance and dissemination of CTO PCI. Successful CTO recanalization has the ability to relieve angina [71], reduce ischemia [41] and the need for CABG [72], improve exercise tolerance [73], electrical stability [74], left ventricular function [44], and tolerance of future ACS [13,75], and possibly survival [76,77] with a similar risk compared to regular PCI of non-CTO lesions [3]. Table 1 summarizes the rationale for CTO PCI.…”

Section: Indications For Cto Pcimentioning

confidence: 99%

“…Traditional predictors for CTO PCI failure are increasing age of the occlusion, small vessel diameter, presence of calcium or a blunt stump, proximal cap ambiguity, excessive tortuosity, long occlusion length, bridging collaterals, and absent visibility of the distal vessel [72,89,[92][93][94][95]. Furthermore, these lesions show a higher mean Multicenter CTO Registry of Japan (J-CTO) score and have collaterals that are less likely suitable for the retrograde approach [96].…”

Section: Procedural Success In Patients With Cto Undergoing Pci or Cabgmentioning

confidence: 99%

Chronic Total Occlusions

2005

The American Journal of Cardiology

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The following chapter provides a brief overview on the prevalence, clinical features, and histological indings in chronically occluded coronary arteries. The role of coronary collaterals and myocardial viability as well as left ventricular function for the evaluation of treatment strategies of chronic total occlusions (CTO) will be discussed. Imaging modalities such as computed tomography and intracoronary imaging are discussed for their signiicance in CTO assessment and intervention. Finally, important clinical and procedural aspects, latest interventional strategies and techniques, the armamentarium of dedicated tools for CTO interventions, as well as evidence from published trials and clinical research in the ield will be presented.

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“…In fact, we reported that successful coronary angioplasty for patients with chronic total occlusion conferred favorable long-term outcomes. 17 Thus, a higher degree of stenosis is a disadvantage for long-term survival in ischemic heart disease, and revascularization of such coronary arteries may have an advantage for long-term survival. This also may be related to the 'open-artery hypothesis'.…”

Section: Lad and Long-term Prognosis In Non-diabetic Patientsmentioning

confidence: 99%

Balloon Coronary Angioplasty and Long-Term Survival of Non-Diabetic Patients With Isolated Severe Left Anterior Descending Coronary Artery Disease.

Tomita

Miyazaki

Morii

et al. 2002

Circ J

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ecently, the BARI study reported that the beneficial effect of bypass surgery on long-term survival was more prominent than that of coronary angioplasty in diabetic patients with multivessel coronary artery disease, 1 related, at least in part, to the disadvantage of coronary angioplasty in such patients; that is, the coronary narrowing in diabetic patients is usually diffuse and small, which results in a small minimal lumen diameter after the intervention and a high restenosis rate. 2,3 Another possible explanation is the general disadvantage of coronary angioplasty in achieving complete revascularization compared with bypass surgery in patients with multivessel disease. In fact, multivessel angioplasties were attempted in 70% of the patients in the BARI study and immediate success was achieved in 78%. 1 Thus, incomplete revascularization may contribute to the difference of survival in the 2 groups. To avoid this problem in the interpretation of the study results from patients with multivessel coronary disease, we investigated the long-term prognosis in diabetic and non-diabetic patients with isolated proximal left anterior descending coronary artery (LAD) disease, because LAD disease has Circulation Journal Vol. 66, June 2002 been reported to have significant survival importance. 4 From 1985From to 1994 consecutive patients who underwent their first elective coronary angiography were identified from the computer database at the National Cardiovascular Center and of these, 681 had isolated proximal LAD disease with more than 90% stenosis. Fourteen patients treated with bypass surgery were excluded and the remaining 667 were enrolled in the present study. They were divided into 2 groups according to their diabetic status: diabetes mellitus (DM) or abnormal glucose tolerance (n=225) and non-diabetic (n=442). They were further subdivided into 2 groups according to the initial therapeutic choice: medical therapy (MED group) or percutaneous transluminal balloon coronary angioplasty (PTCA group). Our definitions of coronary risk factors were: hypertension was defined as more than 140 mmHg systolic blood pressure and/or 90 mmHg diastolic blood pressure; hyperlipidemia was defined as more than 220 mg/dl of total serum cholesterol; DM was diagnosed according to WHO criteria. 5 Methods Patients Coronary Angiography and AngioplastyDiagnostic coronary angiography and left ventriculography were performed using a non-ionic contrast medium (Iopamiron 370, Schering Inc or Iomeron, Eisai Inc). The cine-angiography equipment had a bi-plane system (Toshiba Although long-term survival of diabetic patients with multivessel coronary disease has been reported to be better in those treated with bypass surgery than with coronary angioplasty, it is unclear if diabetic patients who undergo coronary angioplasty show better long-term survival than those treated medically. Between 1985 and 1994, 667 consecutive patients with isolated severe (≥90% diameter stenosis) proximal left anterior descending (LAD) coronary artery disease were...

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Percutaneous transluminal coronary angioplasty of chronic total occlusions. determinants of primary success and long-term clinical outcome

Cited by 211 publications

References 20 publications

Image Post-Processing and Interpretation

Image Post-Processing and Interpretation

Chronic Total Occlusions

Balloon Coronary Angioplasty and Long-Term Survival of Non-Diabetic Patients With Isolated Severe Left Anterior Descending Coronary Artery Disease.

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