Coronary angioplasty of chronic total occlusions with bridging collateral vessels: immediate and follow-up outcome from a large single-center experience

Kinoshita, Isao; Katoh, Osamu; Nariyama, Jin; Otsuji, Satoru; Tateyama, Hitone; Kobayashi, Tohru; Shibata, Nobuhiko; Ishihara, Tadashi; Ohsawa, Nakaaki

doi:10.1016/0735-1097(95)80015-9

Cited by 145 publications

(107 citation statements)

References 19 publications

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“…To facilitate guidewire crossing, new guidewires have been developed, including a ball-tipped wire [2], the laserwire [3], guidewires with hydrophilic coating [4], and stiff wires with high-torque control (Athlete wire, Asahi Intech, Japan). Except for one study [5], these have failed to improve the success rate significantly. The lack of visualization to navigate safely the guidewire through the occlusion site is a major cause of failure.…”

Section: Introductionmentioning

confidence: 99%

Optical coherent reflectometry: A new technique to guide invasive procedures

Yamashita

Kasaoka

Son

et al. 2001

Cathet Cardio Intervent

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The success rate of percutaneous transluminal coronary angioplasty for chronic total arterial occlusions is still unsatisfactory. Inability to cross the lesion with a guidewire is a major cause of failure. Optical coherent reflectometry (OCR) is a new method of using laser light to measure the depth of tissue from the end of an optic fiber. This study tests whether an OCR prototype guidewire provides a guidance system that might be useful to assist reopening chronic total arterial occlusions. An OCR fiber optic within a 0.014″ hypotube was developed using the interference pattern of two reflected light beams (wave length 1,300 nm). To determine if OCR can distinguish different tissue types, plaques of human lower extremity arterial segments were visually divided into three types (calcified, white, or yellow). The slope of the initial reflectance of the OCR curve was calculated and compared between the three groups. In six other arteries, the OCR wire was advanced longitudinally through occluded human artery segments in vitro. Guidewire position was determined by OCR and compared to the position of the guidewire tip observed simultaneously by intravascular ultrasound (IVUS) imaging. In 16 arterial surface segments, calcified plaques had a significantly steeper slope than white or yellow plaques (−227.2 ± 82.2; −81.5 ± 12.9; −103.6 ± 19.6 dB/mm; P < 0.01). For the determination of the guidewire position, IVUS and OCR corresponded correctly in 82% of 28 measurements. Sensitivity and specificity of OCR for detection of plaque versus the media/adventitia boundary were 79% and 89%, respectively (P < 0.001). OCR can distinguish calcified from noncalcified plaque and may distinguish plaque from the media/adventitia boundary. This technology may be useful as a means to help navigate a guidewire safely through an occluded artery. Cathet Cardiovasc Intervent 2001;54:257–263. © 2001 Wiley‐Liss, Inc.

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Section: Introductionmentioning

confidence: 99%

Optical coherent reflectometry: A new technique to guide invasive procedures

Yamashita

Kasaoka

Son

et al. 2001

Cathet Cardio Intervent

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“…This might be considered a failure of conventional 2D-angiography to properly represent stump morphology and true lesion geometry (Safian et al, 1988;Kinoshita et al, 1995). Moreover CTOs are often long lesions length, with severe calcifications and tortuosity (Di Mario et al, 2007), therefore the evaluation of these complex geometric factors is difficult with conventional 2D angiography, often leading to misjudgement of the potential and proper method of treatment (Herrington et al, 1993b).…”

Section: Qca In Chronic Total Occlusionmentioning

confidence: 99%

Quantitative Coronary Angiography in the Interventional Cardiology

Tomasello¹,

Costanzo²,

Galassi³

2011

Advances in the Diagnosis of Coronary Atherosclerosis

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“…Complication rates of CTO PCI were traditionally too high to justify these procedures and success rates were based predominantly on individual operator skills and annual case volume [60,61]. A review of the NHLBI Dynamic Registry revealed a decrease of CTO PCI atempts from 9.6% in 1997/1998 to 5.7% in 2004 [62].…”

Section: Percutaneous Intervention Of Ctomentioning

confidence: 99%

“…Over time, with the improvement of both equipment such as microcatheters and dedicated guidewires with greater torque response [98] and recanalization techniques such as retrograde procedures, safe and efective CTO PCI became possible [60] and most of the prior obstacles vanished [99].…”

Section: Procedural Success In Patients With Cto Undergoing Pci or Cabgmentioning

confidence: 99%

“…Procedural failures during CTO are mainly due to the incapacity to pass the lesion with a guidewire, followed by failed balloon crossing, the inability to dilate the lesion, or a vessel perforation [60,66,[89][90][91]. Traditional predictors for CTO PCI failure are increasing age of the occlusion, small vessel diameter, presence of calcium or a blunt stump, proximal cap ambiguity, excessive tortuosity, long occlusion length, bridging collaterals, and absent visibility of the distal vessel [72,89,[92][93][94][95].…”

Section: Procedural Success In Patients With Cto Undergoing Pci or Cabgmentioning

confidence: 99%

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Chronic Total Occlusions

2005

The American Journal of Cardiology

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The following chapter provides a brief overview on the prevalence, clinical features, and histological indings in chronically occluded coronary arteries. The role of coronary collaterals and myocardial viability as well as left ventricular function for the evaluation of treatment strategies of chronic total occlusions (CTO) will be discussed. Imaging modalities such as computed tomography and intracoronary imaging are discussed for their signiicance in CTO assessment and intervention. Finally, important clinical and procedural aspects, latest interventional strategies and techniques, the armamentarium of dedicated tools for CTO interventions, as well as evidence from published trials and clinical research in the ield will be presented.

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Coronary angioplasty of chronic total occlusions with bridging collateral vessels: immediate and follow-up outcome from a large single-center experience

Abstract: Coronary angioplasty can open chronic total occlusions, with or without bridging collateral channels, for safe and effective recanalization without major complications.

Cited by 145 publications

References 19 publications

Optical coherent reflectometry: A new technique to guide invasive procedures

Optical coherent reflectometry: A new technique to guide invasive procedures

Quantitative Coronary Angiography in the Interventional Cardiology

Chronic Total Occlusions

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