Predictors of prolonged guidewire manipulation time for native coronary chronic total occlusion percutaneous coronary intervention via primary antegrade approach

2021 ◽  
Author(s):  
Yusuke Ochiumi ◽  
Masanori Yamamoto ◽  
Etsuo Tsuchikane ◽  
Toshiya Muramatsu ◽  
Koichi Kishi ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Total Occlusion ◽  
Antegrade Approach ◽  
Percutaneous Coronary

scholarly journals Antegrade Approach of Percutaneous Coronary Intervention for Chronic Total Occlusion

2021 ◽  
Author(s):  
C. Raghu ◽  
Rahul K. Ghogre ◽  
Alekhya Mandepudi
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Chronic Total Occlusion ◽  
Bypass Surgery ◽  
Coronary Intervention ◽  
Technical Expertise ◽  
Total Occlusion ◽  
Antegrade Approach ◽  
Percutaneous Coronary ◽  
Coronary Lesions

AbstractChronic total occlusion (CTO) is a common challenge accounting for 10% of coronary lesions found on coronary angiography. Patients are frequently referred for bypass surgery because percutaneous coronary intervention is challenging in this subset. Recent advances in the hardware as well as the technical expertise and an algorithm approach have improved the success to more than 90%.Antegrade approach is the cornerstone for managing CTO and has two distinct strategies: antegrade wire escalation, and antegrade dissection and reentry strategy. Step-wise approach to perform these procedures and the use of adjunct imaging are discussed.

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

2021 ◽  
Vol 02 (01) ◽  
pp. 031-041
Author(s):  
Rohit Mody
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Success Rate ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Tips And Tricks ◽  
Total Occlusion ◽  
Chronic Total Occlusions ◽  
Antegrade Approach ◽  
Complex Patients ◽  
Percutaneous Coronary

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.

scholarly journals Retrograde Approach to Chronic Total Occlusion Percutaneous Coronary Intervention

2020 ◽  
Vol 13 (5) ◽  
Author(s):  
Michael Megaly ◽  
Iosif Xenogiannis ◽  
Nidal Abi Rafeh ◽  
Dimitri Karmpaliotis ◽  
Stephane Rinfret ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Success Rate ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Retrograde Approach ◽  
Total Occlusion ◽  
Antegrade Approach ◽  
Percutaneous Coronary ◽  
Complex Lesions

The retrograde approach has increased the success rate of chronic total occlusion percutaneous coronary intervention but has also been associated with a higher risk of complications. The retrograde approach is usually performed in complex lesions, in which the antegrade approach is not feasible or has failed previously. Using a systematic 10-step approach can maximize the likelihood of success and minimize the risks of retrograde chronic total occlusion interventions.

scholarly journals Case Report: RETROGRADE APPROACH FOR CTO LESIONS: SERIAL CASE

2017 ◽  
Vol 52 (4) ◽  
pp. 296
Author(s):  
Yudi Her Oktaviono
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Chronic Total Occlusion ◽  
Coronary Bypass ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Retrograde Approach ◽  
Total Occlusion ◽  
Term Survival ◽  
Antegrade Approach ◽  
Percutaneous Coronary

Chronic total occlusion recanalization still represents the final frontier in percutaneous coronary intervention. Successful revascularization is associated with improved long-term survival, reduced symptoms, improved left ventricular function and reduced need for coronary bypass surgery. Retrograde chronic total occlusion recanalization has recently become an essential complement to the classic antegrade approach. Retrograde approach through the collateral channel has been recently proposed and has the potential to improve the success rate of percutaneous coronary intervention (PCI) in chronic total occlusion (CTO) lession of the coronary arteries. We report several cases of successful CTO recanalization procedure using retrograde approach in Soetomo Hospital.

scholarly journals Prediction Score of Antegrade Chronic Total Occlusion Percutaneous Coronary Intervention Success in Dr. Kariadi Central General Hospital Semarang

2020 ◽  
Vol 7 (2) ◽  
pp. 415-421
Author(s):  
Anggit Pudjiastuti ◽  
Sodiqur Rifqi ◽  
Sefri Noventi Sofia
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Side Branch ◽  
Prediction Score ◽  
Total Occlusion ◽  
Antegrade Approach ◽  
Percutaneous Coronary ◽  
Score Model ◽  
Point Total

Background: Lesion characteristics of chronic total occlusion (CTO) are predictors of percutaneous coronary intervention (PCI) success. A prediction score consist of these predictors can help CTO-PCI operators. Various prediction score had been established but none had been established in Indonesian population. Methods: This observational cohort study was performed in patients underwent native vessel CTO-PCI in Dr.Kariadi Hospital during 2018. Target vessels, ostial lesion, blunt stump, calcification, long lesion, bending, side branch, bridging collateral, and retrograde collateral were angiographic variables proposed to be predictors of CTO-PCI success. All of the variables were quantitatively assessed by two observers. Bivariate and multivariate analysis used to identify independent predictors of CTO-PCI success and to establish a scoring model. Results: A total 200 patients underwent CTO-PCI procedures were included to this study. All of the procedures used antegrade approach. The prediction score established as follows: bending (1 point), calcification (2 point), blunt stump (3 point), long lesion (1 point), and poor retrograde collateral filling (2 point). Total score ranged from 0 to 9 with decreased probability of success from 92.3% to 0.5%. Score value ? 3 categorized as difficult lesion with higher risk to failure compared to score value <3 (OR 15.4; p<0.001). The score model had good calibration and discrimination in predict CTO-PCI success (AUC 0.88; p<0.001). Conclusion: Bending, calcification, blunt stump, long lesion, and poor retrograde collateral were predictors of CTO-PCI success. The score consist of these variables could predict antegrade CTO-PCI success. Keywords: chronic total occlusion; percutaneous coronary intervention; success; prediction score.

scholarly journals Mastering retrograde coronary chronic total occlusion intervention in 2021

2021 ◽  
Vol 29 ◽  
pp. 1-12
Author(s):  
Debrabata Dash
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Success Rate ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
High Success Rate ◽  
Total Occlusion ◽  
Antegrade Approach ◽  
Complex Patients ◽  
Percutaneous Coronary ◽  
Initial Description

Chronic total occlusion recanalization still represents the last frontier in percutaneous coronary intervention. Retrograde recanalization is one of the most significant amendments of the technique, and has recently become an essential complement to the classical antegrade approach. It has a high success rate with a low complication profile, despite frequent utilization in the most complex patients. Since its initial description, important iterations have occurred and made the technique safer, faster and more successful.

scholarly journals A Novel Risk Score in Predicting Failure or Success for Antegrade Approach to Percutaneous Coronary Intervention of Chronic Total Occlusion: Antegrade CTO Score

2016 ◽  
Vol 26 (02) ◽  
pp. 089-094 ◽  
Author(s):  
Mohammad Namazi ◽  
Ali Serati ◽  
Hosein Vakili ◽  
Morteza Safi ◽  
Saeed Parsa ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Success Rate ◽  
Failure Rate ◽  
Risk Score ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Total Occlusion ◽  
Antegrade Approach ◽  
Percutaneous Coronary ◽  
Retrograde Filling

AbstractTotal occlusion of a coronary artery for more than 3 months is defined as chronic total occlusion (CTO). The goal of this study was to develop a risk score in predicting failure or success during attempted percutaneous coronary intervention (PCI) of CTO lesions using antegrade approach.This study was based on retrospective analyses of clinical and angiographic characteristics of CTO lesions that were assessed between February 2012 and February 2014. Success rate was defined as passing through occlusion with successful stent deployment using an antegrade approach.A total of 188 patients were studied. Mean ± SD age was 59 ± 9 years. Failure rate was 33%. In a stepwise multivariate regression analysis, bridging collaterals (OR = 6.7, CI = 1.97–23.17, score = 2), absence of stump (OR = 5.8, CI = 1.95–17.9, score = 2), presence of calcification (OR = 3.21, CI = 1.46–7.07, score = 1), presence of bending (OR = 2.8, CI = 1.28–6.10, score = 1), presence of near side branch (OR = 2.7, CI = 1.08–6.57, score = 1), and absence of retrograde filling (OR = 2.5, CI = 1.03–6.17, score = 1) were independent predictors of PCI failure. A score of 7 or more was associated with 100% failure rate whereas a score of 2 or less was associated with over 80% success rate.Most factors associated with failure of CTO-PCI are related to lesion characteristics. A new risk score (range 0–8) is developed to predict CTO-PCI success or failure rate during antegrade approach as a guide before attempting PCI of CTO lesions.

scholarly journals Conquering Retrograde Coronary Chronic Total Occlusion Intervention: Review of recent Developments

2021 ◽  
Vol 02 (01) ◽  
pp. 042-052
Author(s):  
Rohit Mody
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Success Rate ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Tips And Tricks ◽  
Total Occlusion ◽  
Antegrade Approach ◽  
Complex Patients ◽  
Percutaneous Coronary ◽  
Recent Developments

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. In this article, we describe various tips and tricks which can help in increasing the success rate of retrograde CTO PCI. Various complications, their preventions, and treatments, if they occur, have been described.

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