The presence of calcified lesions worsens percutaneous coronary intervention prognosis, presenting more restenosis, thrombosis and need for new revascularization. The aim of this study was to assess the superiority of CTO with a prespecified management algorithm on a conventional angiography treatment, in addition to assessing CTO safety. A superiority randomized study was carried out including...
The aim of this randomized open study was to determine whether CTO guided left main percutaneous coronary intervention (PCI) is superior to fluoroscopy guided PCI, using fractional flow reserve (FFR) after stenting. The secondary outcomes were procedural success (successful implantation, malposition, edge dissection or stent collapse) and major adverse cardiovascular events (MACE) at one year....
Technological advancements and technique improvements have significantly enhanced the success rate of percutaneous interventions for treating chronic total occlusions (CTO). Angiographic scores and CTO-PCI algorithms are valuable tools that help us select the optimal strategy when planning these procedures. The retrograde strategy, specifically, has proven beneficial in addressing complex CTOs. However, standardized tools to predict...
Chronic total occlusion (CTO) affect up to 20% of patients undergoing angiographic diagnostic tests. During the last two decades, recanalization technique refinement, the development of specific devices and operator skill improvement have elevated procedural success rate up to 90%. However, there are still particular complications such as collateral perforation and access site complications. This is...
Extracranial carotid artery disease represents 15 to 20% of all strokes. Carotid revascularization plays a role in primary and secondary prevention of cerebrovascular events. Outcomes of two common revascularization strategies, Carotid endarterectomy (CAE) and carotid artery stenting (CAS), have been studied and compared. In recent years, complications associated to CAS have dropped thanks to technical...
Patients with peripheral vascular disease often experience femoropopliteal compromise. It is estimated that approximately 50% of lesions in this area are chronic total occlusions (CTO). Even though success rate has improved for peripheral CTO treatments, long term clinical and technical outcomes have not been fully determined yet. Prior research has looked into stenting outcomes in...
Chronic total occlusions (CTO) occur in up to 20% of patients undergoing diagnostic angiographic studies. Over the past two decades, the optimization of recanalization techniques, the development of new specialized devices, and improvement in operator skill have contributed to an increased procedural success rate, reaching 90%. However, specific complications such as collateral perforation and access...
Roughly 20% or coronary angiographies show some form of chronic total occlusion (CTO), and this figure is twice as high for diabetic patients or those with cardiac failure and reduced ejection fraction (EF). CTO percutaneous intervention (PCI) has experienced a significant growth thanks to the development of new techniques and dedicated material. However, a considerable...
Severely calcified coronary stenosis poses a significant challenge for coronary angioplasty procedures. Modifying plaque before stenting is crucial to a successful intervention, since it will prevent the sub expansion associated to worse clinical outcomes at followup. The tools employed to assess complex lesions include specialized balloons such as cutting, scoring, or high pressure balloons, as...
The antegrade dissection and re-entry (ADR) technique is considered essential for the management of chronic total occlusions (CTO). It serves as the primary option in some protocols for complex and extensive lesions or as a backup strategy in case of failure with other initial strategies. Dissection techniques include guided methods such as scratch and go,...