Safety and effectiveness of the surfing technique to cross septal collateral channels during retrograde chronic total occlusion percutaneous coronary intervention

Dautov, Rustem; Ureña, Marina; Gibrat, Claire; Rinfret, Stéphane

doi:10.4244/eij-d-16-00650

Cited by 45 publications

(32 citation statements)

References 14 publications

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“…[ 3 ] However, a diminutive collateral channel size coupled with tortuosity of the collateral vessels are critical risk factors which may result in an increased rate of complications as well as failure of the retrograde PCI. [ 4 , 5 ]…”

Section: Discussionmentioning

confidence: 99%

Use of sodium nitroprusside in retrograde percutaneous coronary intervention for chronic total occlusion

et al. 2018

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Rationale:Chronic total occlusion continues to be a challenging lesion subset for percutaneous coronary intervention.Patient concerns:A 65-year-old male patient was admitted with symptoms of angina pectoris for 9 months.Diagnoses:Coronary angiography showed a severe stenosis in the proximal left anterior descending artery and a chronic total occlusion (CTO) in the proximal right coronary artery. The complexity of the CTO was stratified using the J-CTO score and the PROGRESS CTO score.Interventions:Antegrade wire escalation for CTO of RCA failed. The septal collaterals to RCA were initially judged to be poor and not suitable for intervention.Outcomes:However, administration of sodium nitroprusside improved collateral flow and enabled the identification of retrograde channels suitable for wire crossing and successful retrograde PCI.Lessions:The study showed that faintly visible to even invisible septal collateral connections can be crossed with the septal “trial and error” surfing technique after the administration of sodium nitroprusside.

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Section: Discussionmentioning

confidence: 99%

Use of sodium nitroprusside in retrograde percutaneous coronary intervention for chronic total occlusion

et al. 2018

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“…74,76,79 Dautov et al assessed the safety and effectivity of the septal surfing technique in 240 retrograde PCIs, showing successful septal crossing in 81% of the cases. 81 Mashayekhi et al 82 P>0.05), with low crossover rates (ipsilateral to contralateral, 11%; contralateral to ipsilateral, 4%) and a similar major complications rate (5% versus 7%; P=1.00). 82 However, epicardial collateral perforation can rapidly cause tamponade and may require urgent sealing from both directions, 83 usually with coils, fat, or thrombin.…”

Section: Retrograde Approachmentioning

confidence: 90%

“…Dautov et al assessed the safety and effectivity of the septal surfing technique in 240 retrograde PCIs, showing successful septal crossing in 81% of the cases 81. Mashayekhi et al82 compared the outcomes of retrograde CTO PCI via ipsilateral (n=44 [28%]) with contralateral (n=114 [72%]) collateral connections.…”

Section: Retrograde Approachmentioning

confidence: 99%

Chronic Total Occlusion Percutaneous Coronary Intervention: Evidence and Controversies

Tajti

Brilakis

2018

JAHA

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“…В недавнем исследовании R. Dautov и соавт. показали, что даже невидимые на ангиограммах септальные сосуды могут быть успешно пройдены проводником, и их использование ассоциировано с высокой частотой успеха [29]. В нашем исследовании для ретроградной реканализации в 91 % случаев использовались септальные артерии.…”

Section: результатыunclassified

Recanalization of Chronic Total Occlusions Using Modern Endovascular Techniques

et al. 2019

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Purpose:to assess results of percutaneous coronary intervention (PCI) with contemporary endovascular techniques of recanalization of chronic total coronary artery occlusions (CTO) in patients with ischemic heart disease (IHD). Occlusion (CTO) he procedural and in-hospital outcomes of consecutive patients undergoing chronic total occlusion percutaneous coronary intervention.Materials and methods.We retrospectively analyzed data from 456 consecutive patients (mean age 59.9±7.1 years, 18.2 % women) who underwent CTO PCI procedures (n=477) during 2014–2016 in the E. N. Meshalkin National Medical Research Center. CTO was localized in the right (61.2 %), left anterior descending (23.2 %) and left circumflex (15.3 %) coronary arteries. In one patient CTO was located in the left main coronary artery. According to the J-CTO score, 30 % of lesions were classified as easy, 36.4 % intermediate, 23.7 % difficult, and 18.9 % very difficult.Results.Technical and procedural successes were achieved in 374 (78.4 %) and 366 patients (76.7 %), respectively. Antegrade approach was used in 378 (79.2 %), retrograde approach – in 99 (20.7 %) cases. Retrograde approach as primary strategy was used in 27 cases (5.7 %). Most frequent access for CTO PCI was radial artery, contralateral injection was used in 151 cases (31.6 %). Total number of stents per lesion was 1.6±0.98. The mean fluoroscopy time was 36.2±31 min.Conclusions.The rate of procedural adverse events in our study was low and similar to the non-CTO PCI series. However, despite the large number of CTO PCIs, the procedural success rate was still lower than in centers with dedicated programs for the management of such patients. Thus, further work is required to overcome this difference. Possible solution of this problem might be development and introduction in clinical practice of an algorithm for CTO recanalization.

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Safety and effectiveness of the surfing technique to cross septal collateral channels during retrograde chronic total occlusion percutaneous coronary intervention

Abstract: Septal surfing is a safe and highly successful technique for crossing septal CCs when a retrograde approach is mandated for CTO PCI. The Werner class does not affect retrograde CC crossing success or time.

Cited by 45 publications

References 14 publications

Use of sodium nitroprusside in retrograde percutaneous coronary intervention for chronic total occlusion

Use of sodium nitroprusside in retrograde percutaneous coronary intervention for chronic total occlusion

Chronic Total Occlusion Percutaneous Coronary Intervention: Evidence and Controversies

Recanalization of Chronic Total Occlusions Using Modern Endovascular Techniques

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