Percutaneous transluminal coronary angioplasty for chronic total coronary arterial occlusion

Melchior, J. P.; Meier, Bernhard; Urban, Philippe; Finci, Léo; Steffenino, Giuseppe; Noble, Jacques; Rutishauser, W.

doi:10.1016/0002-9149(87)91164-7

Cited by 158 publications

(55 citation statements)

References 10 publications

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“…The frequency of such a wire complication is reported to be 10-20% [4,6]. Depending on the localization of the subintimal pathway, further effort may be undertaken to achieve a distal reentry of the wire into the true lumen.…”

Section: Discussionmentioning

confidence: 99%

“…The complication rate of the recanalization procedure is comparable to angioplasty in nonocclusive lesions [1], but the success rate in chronic occlusions is only 60-70% [1][2][3][4][5]. Besides the failure to cross the lesion, another problem could be the deviation of the guide wire in a subintimal pathway [3,6]: even though the occlusion is crossed, a persistent antegrade flow cannot be established. We present our observations in three cases with a subintimal wire pathway, in which we successfully achieved a distal reentry into the true vessel lumen.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Vessel reconstruction in total coronary occlusions with a long subintimal wire pathway: Use of multiple stents under guidance of intravascular ultrasound

Werner

Diedrich

Scholz

et al. 1997

Cathet. Cardiovasc. Diagn.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Vessel reconstruction in total coronary occlusions with a long subintimal wire pathway: Use of multiple stents under guidance of intravascular ultrasound

Werner

Diedrich

Scholz

et al. 1997

Cathet. Cardiovasc. Diagn.

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“…However a recent large series by Melchior et al [7] and LaVeau et al [8] have shown very low success rates (1 1 %, 0%) for chronic total occlusions of > 6 months duration. In contrast other investigators have reported less influence of occlusion duration on primary success.…”

Section: Duration Of Occlusionmentioning

confidence: 96%

Angioplasty of a totally occluded right coronary artery

Taylor

Vetrovec

1992

Cathet. Cardiovasc. Diagn.

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We have presented a case of angioplasty of a chronically occluded right coronary artery. The occlusion had been present for 6 wks by clinical estimates. The length of the occluded segment (approximately 55 cm) did not preclude a successful outcome. Proper selection and manipulation of angioplasty equipment are, as in every case, critical for procedural success. Subintimal guidewire passage, though a frequent event, is occasionally associated with ischemic manifestations, and mandates detection and proper management. New approaches to PTCA of total coronary occlusions continue to be developed.

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“…From the technical point of view, PTCA of chronically occluded vessels is considered a low-risk intervention, but with less favorable primary success and more frequent restenosis [4,5,9]. Accordingly, several techniques have been suggested in order to improve initial success rate [7,11-131. We describe a new method consisting of use of a thick and relatively stiff open-ended guidewire.…”

Section: Introductionmentioning

confidence: 99%

Open‐Ended guidewire: New technique for balloon angioplasty of chronically occluded coronary arteries

Vassanelli¹,

Turri²,

Morando³

et al. 1989

Cathet. Cardiovasc. Diagn.

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Chronic total coronary occlusion is a growing indication to percutaneous transluminal coronary angioplasty. Since primary success of balloon angioplasty in this condition is usually limited by the difficulty of crossing the occlusion, different techniques have been described for this purpose, such as use of stiff guidewires, coronary infusion catheters, guidewires with an olive-shaped tip, or new developing methods (atherectomy, laser), in association with balloon dilatation. Here, we describe our initial experience with a thick (0.035 in) and relatively stiff open-ended guidewire, which has an inner (0.018 in diameter) lumen provided with a core wire. Several advantages are considered. The core wire yields a perfect means of steerability of the whole system, while pushability of a thicker guidewire is much greater. Moreover, the core wire can be removed, and contrast injections beyond the occlusion through the inner lumen can assure proper intraluminal location. Finally, position across the occlusion can be kept easily, since an exchange wire for conventional balloon catheters can be inserted in the inner lumen of the open-ended guidewire.

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Percutaneous transluminal coronary angioplasty for chronic total coronary arterial occlusion

Cited by 158 publications

References 10 publications

Vessel reconstruction in total coronary occlusions with a long subintimal wire pathway: Use of multiple stents under guidance of intravascular ultrasound

Vessel reconstruction in total coronary occlusions with a long subintimal wire pathway: Use of multiple stents under guidance of intravascular ultrasound

Angioplasty of a totally occluded right coronary artery

Open‐Ended guidewire: New technique for balloon angioplasty of chronically occluded coronary arteries

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