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 the SBHCI. Chronic total occlusions represent around 18% of all coronary lesions. However, they account for just 5% of all interventions, which means that many patients only receive medical treatment. This prospective, open, multicenter study randomized patients with multivessel lesions in whom at least one of these was a chronic total occlusion. Patients...
Courtesy of SBHCI. The PRISON IV trial compared the sirolimus eluting stent with ultra-thin struts and biodegradable polymer vs. the second-generation everolimus-eluting stent with thin struts and durable polymer in successfully recanalized chronic total occlusions. This is a sub-study with optical coherence tomography (OCT). The study included 330 patients, 85% angiographically followed up at...
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...
While the use of intravascular ultrasound (IVUS) during coronary intervention proved useful in multiple studies, there is limited evidence in the literature regarding its use in specifically in chronic total occlusions. The IVUS may help guide in recognizing the true lumen and better distal positioning, better coverage of stent, an optimal apposition and expansion, diagnose...
Original title: Safety and Effectiveness of Everolimus-Eluting Stents in Chronic Total Coronary Occlusion Revascularization Results From the EXPERT CTO (Evaluation of the XIENCE Coronary Stent, Performance, and Technique in Chronic Total Occlusions) Multicenter Trial. Reference: David E. Kandzari et al. J Am Coll Cardiol Intv. 2015, on line before print. The aim of this study was to evaluate...
Original title: Angiographic Success and Procedural Complications in Patients Undergoing Percutaneous Coronary Chronic Total Occlusion Interventions. A Weighted Meta-Analysis of 18,061 Patients From 65 Studies. Reference: Vishal G. Patel et al. J Am Coll Cardiol Intv 2013. Article in press. Chronic Total Occlusions (CTOs) are found in between 15% and 30% of patients undergoing coronary angioplasty. Successful CTOs...
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...
A lesion ≥50% in the left main coronary artery (LMCA) is considered severe, according to various scientific societies, regardless of the presence of symptoms or ischemia, due to the extent of myocardium at risk. In such cases, revascularization is indicated. In many patients, lesions in this section of the coronary artery have severe calcification, which...
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...