The Impact of Calcium on Chronic Total Occlusion Management

Coronary artery calcification is prevalent in chronic total occlusions (CTO), particularly in those of longer duration and post-coronary artery bypass. The presence of calcium predicts lower procedural success rates and a higher risk of complications of CTO percutaneous coronary intervention. Adjunc...

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Autores principales: Claudia Cosgrove, Kalaivani Mahadevan, James C Spratt, Margaret McEntegart
Formato: article
Lenguaje:EN
Publicado: Radcliffe Medical Media 2021
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Acceso en línea:https://doaj.org/article/2d26e623d6be459580a6d6c80c2a3881
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Sumario:Coronary artery calcification is prevalent in chronic total occlusions (CTO), particularly in those of longer duration and post-coronary artery bypass. The presence of calcium predicts lower procedural success rates and a higher risk of complications of CTO percutaneous coronary intervention. Adjunctive imaging, including pre-procedural computed tomography and intracoronary imaging, are useful to understand the distribution and morphology of the calcium. Specialised guidewires and microcatheters, as well as penetration, subintimal entry and luminal re-entry techniques, are required to cross calcific CTOs. The use of both atherectomy devices and balloon-based calcium modification tools has been reported during CTO percutaneous coronary intervention, although they are limited by concerns regarding safety and efficacy in the subintimal space.