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...
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...
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...
Read articles on the main presentations of the first day of SOLACI-SOCIME 2018 Congress. See the presentation by Dr. Jaikirshan Khatri, entitled “Justification of PCI for Coronary Chronic Total Occlusion”. We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.
Dyspnea is one of the most challenging symptoms as regards its assessment and treatment in patients with coronary disease, since it may stem from both cardiac and non-cardiac causes. Patients in whom dyspnea is the sole symptom of coronary disease are at a higher risk of not receiving adequate treatment, and their short- and long-term...
Even in the hands of experienced operators, rechanneling and angioplasty of a chronic total occlusion (CTO) results in patients and the whole cath lab team receiving high doses of radiation, according to this registry presented at the American Heart Association 2017 Scientific Sessions. Up to 23% of patients who undergo rechanneling of a CTO receive...
Collateral circulation develops during the gradual progression of coronary occlusions in order to replace the original artery and supply blood to areas jeopardized by ischemia. However, the relevance of collaterals has remained controversial for many years. Several works have suggested a rapid regression of collaterals after rechanneling of chronic total coronary occlusions, which could render...
Although chronic total occlusion (CTO) is a common finding, there is little consensus as to when such lesions should be treated routinely with angioplasty. Benefits of successful rechanneling include relief of symptoms, resolution of ischemia, improvement in ventricular function, and avoidance of myocardial revascularization surgery. Unsuccessful rechanneling is common and may be associated with several adverse events,...
Courtesy of Dr. Carlos Fava. Nowadays, the number of coronary angioplasties carried out on patients with chronic total occlusion (CTO) is increasing due to many studies showing that it improves ventricular function, reduces symptoms, and improves survival. However, most of these works do not include patients of over 75 years old due to their frailty and...
There is little evidence to support the safety and efficacy of bioresorbable scaffolds (BRS) for the treatment of chronic total occlusions (CTO). This multicenter registry included consecutive patients with CTO receiving BRS (Absorb; Abbott Vascular) vs. 2nd generation drug eluting stents (DES). Primary end point was target vessel failure at long term (composite...