Total occlusions articles

Lower Mortality with Rechanneling vs. Medical Therapy

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

Suboptimal Recanalization Results Worse than Procedural Failure

This large cohort of patients undergoing PCI for chronic total occlusion has shown suboptimal recanalization is associated with cardiac death and myocardial infarction at long term compared against procedural failure.  The link between acute outcomes and long-term events in recanalizations has been overlooked. Mainly when it comes to suboptimal results, is doing something more trouble

Virtual ACC 2020 | TWILIGHT-COMPLEX: Ticagrelor Monotherapy in the Most “Dangerous” Angioplasties

The original TWILIGHT findings in more than 9000 patients who underwent angioplasty were presented last year at TCT and showed a 3.1% absolute risk reduction in BARC 2, 3, or 5 bleeding with no increase in death, infarction, or stroke in patients who received ticagrelor and placebo compared with patients who received ticagrelor and aspirin. All patients

Subintimal vs. Intraplaque Coronary Rechanneling. Do Results Vary?

Coronary rechanneling is difficult by nature, and there are several techniques for it aimed at improving technical success. Some of these strategies entail the subintimal crossing of the occluded segment, while others entail intraplaque crossing, without leaving the true lumen. However, there is scarce or no information on the results of both strategies. Researchers analyzed

Highlights TCT 2019

TCT 2019 | EURO-CTO: Results at 3 Years of CTO Recanalization vs. Optimal Medical Treatment

Courtesy of SBHCI. Between 16 and 18% of coronary artery lesions in patients with chronic stable CAD are chronic total occlusions (CTO). CTO revascularization could benefit symptomatic patients, but it remains unclear whether such complex procedure is safe in the long run, given the study outcomes on PCI in CAD so far.  This study presented

Antianginal Medication Before and After Rechanneling

Escalation or de-escalation of antianginal medication was less common than treatment continuation without change after a chronic total occlusion rechanneling, with little variation according to the site. Further research is needed to identify patients who would benefit (or not) from these drugs and to develop strategies to adjust treatment during follow-up. This work basically tells

TAVI en insuficiencia aórtica pura, nuevos dispositivos con nuevos resultados

The FDA Affirms Mortality Signs with Paclitaxel Based Devices

Evidently, we are still uncertain. The information goes both ways, even on our own web page, we have been coming and going just like any other publication around the world. After a 2-day debate, the Circulatory System Devices FDA panel has confirmed the tendency to higher mortality with paclitaxel-based devices and is expected to debate

Costos hospitalarios y de las complicaciones de las oclusiones totales crónicas

In-Hospital Costs and Costs of Complications of Chronic Total Occlusions

Is a chronic total occlusion worth rechanneling? This question can often be found in different studies, all of them with clinical endpoints. This study (soon to be published in J Am Coll Cardiol Intv.) analyzes another aspect: costs, not only derived from materials used for a successful procedure, but also from materials and hospital stay

Successful CTO Reduces Local and Remote Residual Ischemia

CTO: in Radial Access with Similar Results to Femoral

Courtesy of Dr. Carlos Fava. One of the characteristics of chronic total occlusion (CTO) is the use of two access routes: femoral and radial. The radial approach is safer, but it has not been thoroughly analyzed in this type of PCI. The study looked at 3709 patients undergoing left main percutaneous coronary intervention (PCI) for

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

Clinical Improvement Without Ventricular Function Improvement After CTO

The benefits offered to patients by attempting the rechanneling of a chronic total occlusion are still unclear. Additionally, sometimes the procedural risks are somewhat undetermined. Taking into account these controversies, this work sought to prove whether successful rechanneling of a chronic total occlusion improves ventricular function. This is not a soft endpoint; it has been

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