Transient Impairment of Vasomotion Function After Successful Chronic Total Occlusion Recanalization

Galassi, Alfredo R.; Tomasello, Salvatore D.; Crea, Filippo; Costanzo, Luca; Campisano, Maria Barbara; Marzà, Francesco; Tamburino, Corrado

doi:10.1016/j.jacc.2011.10.894

Cited by 86 publications

(47 citation statements)

References 25 publications

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“…The recanalization of CTO is usually associated with better long-term outcomes. 1,2) However, the CTO recanalization success rate is variable and its main challenge is to advance the guidewire through the occlusion segment. Recently, the overall success rate has increased, thanks to the introduction of multiple intervention strategies, such as the parallel wire technique, 3) confluent balloon technique, 4) reverse controlled anterograde and retrograde sub-intimal tracking (CART) or reverse-CART technology, 5) as well as the development of new equipment.…”

Section: T Is Of Great Interest For Treating Chronic Total Occlusionmentioning

confidence: 99%

Usefulness and Safety of a Novel Modification of the Retrograde Approach for the Long Tortuous Chronic Total Occlusion of Coronary Arteries

et al. 2017

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SummaryThe aim of this study was to evaluate the feasibility and efficacy of the Guidezilla guide extension catheter in a reverse controlled antegrade and retrograde subintimal tracking (CART) technique for chronic total occlusion (CTO) recanalization.We retrospectively collected 80 CTO cases using reverse CART technology from January 2015 to October 2015 and 20 CTO cases using Guidezilla reverse-CART technology from October 2015 to March 2016. Guidezilla was applied in cases when it was difficult to advance a retro-guidewire through an occlusion segment into the antegrade guide catheter.The Guidezilla group had more cases with an occlusion longer > 20 mm (100.0% versus 72.5%, P = 0.005) and "bending > 45°" (90.0% versus 63.7%, P = 0.029) than the non-Guidezilla group, while the non-Guidezilla group had more retry lesions (25.0% versus 63.8%, P = 0.002). The septal collateral channel was the preferred choice for retro-recanalization in both groups (90.0% in Guidezilla group and 68.8% in non-Guidezilla group). All cases in the Guidezilla group achieved technical success with a TIMI 3 flow in the distal true lumen (100.0% versus 75.0% in non-Guidezilla group, P = 0.010). Cardiac tamponade and perforation in the epicardial artery was observed in 1 case each in the Guidezilla group. In the non-Guidezilla group, 19 complications occurred during the PCI procedure. No target vessel revascularization or in-hospital death occurred in either group.CTO lesions using the Guidezilla guide extension catheter to facilitate entry to an antegrade catheter in reverse CART technology is convenient and safe with a high success rate. (Int Heart J 2017; 58: 351-356)

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Section: T Is Of Great Interest For Treating Chronic Total Occlusionmentioning

confidence: 99%

Usefulness and Safety of a Novel Modification of the Retrograde Approach for the Long Tortuous Chronic Total Occlusion of Coronary Arteries

et al. 2017

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“…Even after successful revascularization of the target lesion, the vessel may not dilate immediately because of impaired endothelial function. 15 In our study, intracoronary nitrates were administered before CAG or IVUS imaging. Therefore, not only endothelium-dependent but also endothelium-independent vessel dilatation of the distal segments may be impaired.…”

Section: Study Limitationsmentioning

confidence: 99%

“…Therefore, not only endothelium-dependent but also endothelium-independent vessel dilatation of the distal segments may be impaired. 15 Vessel shrinkage may occur during coronary spasm or compression of the coronary artery by a myocardial bridge. Coronary spasm can be excluded by the administration of nitrates.…”

Section: Study Limitationsmentioning

confidence: 99%

Prediction of Chronic Vessel Enlargement by a Novel Intravascular Ultrasound Finding

Neishi

Okura

Kume

et al. 2015

Circ J

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A total of 27 patients who underwent successful IVUS-guided percutaneous coronary intervention (PCI) for severe coronary stenosis were retrospectively selected and enrolled from our IVUS database. Inclusion criteria were lesions with chronic total occlusion (CTO) or severely stenotic lesions (%diameter stenosis >90% and delayed distal flow) with angiographic follow-up at 9 months. Exclusion criteria were culprit lesions for acute myocardial infarction, lesions without final IVUS imaging of the distal reference segments and presence of target lesion restenosis or re-occlusion at follow-up. All patients gave written informed consent. Angiography and Interventional ProceduresAfter intravenous or intraarterial bolus injection of heparin (5,000-10,000 units), coronary angiography (CAG) and the PCI were performed by standard femoral or radial approach oronary arterial segments distal to the severely stenotic or occluded lesion usually shrink as a result of chronically decreased coronary flow. Although differentiation of residual organic stenosis and vessel shrinkage that has the potential to reverse 1 without additional intervention is clinically important in the catheterization laboratory, no specific angiographic, intravascular ultrasonographic or optical coherence tomographic 2-4 findings have been shown.Recent pathological studies have suggested that vessel spasm or shrinkage is accompanied by folding of the internal elastic membrane (IEM). 5,6 Intravascular ultrasound (IVUS) may visualize the folding of the IEM as a high-echoic band and thus could detect chronically shrunken vessels that have potential to enlarge late after revascularization.We hypothesized that a novel IVUS finding, a peri-medial high-echoic band (PHB), would predict chronic vessel enlargement of the distal coronary segments after intervention of the severely stenotic proximal target lesion.

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“…However, automatic analysis of OCT sequence is likely to provide much more information, such as score maps and quantitative diagnosis indices. Automatic tools are becoming more efficient in cardiology particularly artery diseases, for example in chronic total occlusion recanalization [7,8]. Then, several studies developed automatic algorithm in order to detect the lumen border and the struts in OCT sequences [9][10][11][12][13][14][15] whereas Wang et al stayed focused only on the strut detection [16].…”

Section: Introductionmentioning

confidence: 99%

Automated peroperative assessment of stents apposition from OCT pullbacks

Dubuisson¹,

Péry²,

Ouchchane³

et al. 2015

Computers in Biology and Medicine

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Transient Impairment of Vasomotion Function After Successful Chronic Total Occlusion Recanalization

Cited by 86 publications

References 25 publications

Usefulness and Safety of a Novel Modification of the Retrograde Approach for the Long Tortuous Chronic Total Occlusion of Coronary Arteries

Usefulness and Safety of a Novel Modification of the Retrograde Approach for the Long Tortuous Chronic Total Occlusion of Coronary Arteries

Prediction of Chronic Vessel Enlargement by a Novel Intravascular Ultrasound Finding

Automated peroperative assessment of stents apposition from OCT pullbacks

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