Total occlusions articles

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The Best of SOLACI-SOCIME 2022 Main Arena – Chronic Total Occlusions (CTO)

The Best of SOLACI-SOCIME 2022 Main Arena – Chronic Total Occlusions (CTO)

How to Choose the Best Approach in Chronic Total Occlusions, by Dr. Jean-Michel Paradis CTO are present in around 16 to 20% of patients with coronary artery disease who get a coronary angiography. CTO Percutaneous intervention has been on the rise, mainly due to equipment and technique advancement. During his presentation, Dr. Paradis mentioned the

Cortar las valvas, una medida extrema para evitar la oclusión coronaria post TAVI

CTO: Trials vs. Real-World

Percutaneous coronary intervention of chronic total occlusions (CTO) is currently indicated for symptom improvement, as studies have inadequate randomization of data which hinders the assessment of hard outcomes. However, patient inclusion in randomized controlled trials has been challenging, especially for highly symptomatic and higher risk patients. This causes a selection bias in randomized studies on

Progress-CTO Score: A Key New Tool to Plan CTO

Intervention of chronic total occlusions (CTO) through angioplasty (PCI) can cause complications, even in highly experienced centers. Plenty has been written on the probability of success for the treatment of CTOs using scores such as CL-SCORE, J-CTO, ORA, E-CTO, CASTLE-CTO, etc. (some of which are usually used when preparing these cases). However, besides estimating success

Disnea y oclusiones totales crónicas: un síntoma que podemos aliviar (o al menos intentarlo)

Changes in Coronary Collateral Function Post CTO Intervention

In the last few years, we have seen significant growth of chronic total occlusion (CTO) percutaneous intervention, which has also been considered for patients with viable territory that remain symptomatic. Experienced centers present successful CTO intervention rates close to 90%, especially with a hybrid approach. However, it is still a complex procedure, and target vessel

EuroPCR 2022 | Cambios en el daño cardíaco luego del reemplazo valvular aórtico por cirugía

EuroPCR 2022 | The IMPROVED-CTO Trial

PCI success rate in chronic total occlusion (CTO), according to some registries, is below 80%. These failed revascularization procedures might lead to quality-of-life deterioration and shorter survival. This concern has driven the development of new techniques and technologies in an attempt to increase PCI success. Today, approximately 20% of CTOs are treated with a second

Acceso femoral vs Acceso radial en el tratamiento percutáneo de CTO.

Transfemoral vs Transradial Approach in the Percutaneous Treatment of CTO

Percutaneous treatment of chronic total occlusion (CTO) has traditionally been via the transfemoral approach (TFA). The use of the transradial approach (TRA) in complex coronary interventions has been increasing. A randomized study assessed the use of TRA vs TFA in complex PCI (58% CTO) and TRA saw favorable outcomes. The aim of this prospective, randomized,

Un truco sencillo para mejorar nuestras punciones radiales

Can the Use of Intra Arterial Vasodilators Prevent Radial Artery Occlusion?

The incidence of post procedure radial occlusion (RAO) ranges from 1% to 12 % according to some studies. Different strategies to reduce RAO include the use of small caliber catheters, adequate anticoagulation and punction site care after procedure.  Vasodilators are used to prevent radial spasm during procedure. However, using it after procedure should increase flow,

EuroPCR 2021 | COLOR: Angioplastias complejas por acceso radial vs femoral

EuroPCR 2021 | COLOR: Complex PCI via Transradial vs Transfemoral Approach

Treating total occlusions, complex bifurcations, grossly calcified lesions or left main lesions via transradial approach is associated with significant reduction in access-site bleeding or vascular complications vs transfemoral approach. This kind of procedures have been typically excluded from studies randomizing patients to transradial vs transfemoral approach.  The COLOR study used the transradial bore-guiding catheter Glidesheath

Bilateral Distal Transradial Access for Chronic Total Occlusion Recanalization and Multivessel Coronary Disease Percutaneous Intervention

[APT Medical Sponsored Clinical Case] Bilateral Distal Transradial Access for Chronic Total Occlusion Recanalization and Multivessel Coronary Disease Percutaneous Intervention

Introduction Chronic total occlusion (CTO) represents the most challenging setting for percutaneous coronary intervention (PCI) and multivessel coronary disease (MCD) is often treated in a staggered manner and in a deferred procedure. Although transfemoral is one of the common access site, the transradial access (TRA) has been used with similar procedural success [1]. The distal

Lower Mortality with Rechanneling vs. Medical Therapy

We had to wait for it, but we have finally seen a benefit in hard endpoints—such as mortality—derived from rechanneling. Patients with chronic total occlusion (CTO) in whom rechanneling was used as initial strategy showed higher survival rated compared with those receiving medical therapy. As initial treatment strategy, rechanneling a CTO did not show any

¿En qué pacientes intentar la recanalización de una oclusión crónica total?

Should Total Occlusion Influence on Revascularization Strategy?

Success or failure of total occlusion (TO) revascularization does not affect mortality at 10 years, and this does not depend on revascularization strategy (PCI vs surgery) or location.  The long-term clinical benefit of recanalization and PCI or TO artery bypass graft remains nuclear.  This is a sub-study of the SYNTAXES (Synergy Between PCI With Taxus