Factors Influencing Stent Failure in Chronic Total Occlusion Coronary Intervention

Stent failure remains one of the greatest challenges for interventional cardiologists. Despite the evolution to superior second- and third-generation drug-eluting stent designs, increasing use of intracoronary imaging and the adoption of more potent antiplatelet regimens, registries continue to demo...

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Autores principales:	Kalaivani Mahadevan, Claudia Cosgrove, Julian W Strange
Formato:	article
Lenguaje:	EN
Publicado:	Radcliffe Medical Media 2021
Materias:	Surgery RD1-811 Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/6ba0aba00e714a9fad10c9441f5a0812
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spelling	oai:doaj.org-article:6ba0aba00e714a9fad10c9441f5a08122021-12-04T16:05:01ZFactors Influencing Stent Failure in Chronic Total Occlusion Coronary Intervention10.15420/icr.2021.031756-14851756-1477https://doaj.org/article/6ba0aba00e714a9fad10c9441f5a08122021-10-01T00:00:00Zhttps://www.icrjournal.com/articleindex/icr.2021.03https://doaj.org/toc/1756-1477https://doaj.org/toc/1756-1485Stent failure remains one of the greatest challenges for interventional cardiologists. Despite the evolution to superior second- and third-generation drug-eluting stent designs, increasing use of intracoronary imaging and the adoption of more potent antiplatelet regimens, registries continue to demonstrate a prevalence of stent failure or target lesion revascularisation of 15–20%. Predisposition to stent failure is consistent across both chronic total occlusion (CTO) and non-CTO populations and includes patient-, lesion- and procedure-related factors. However, histological and pathophysiological properties specific to CTOs, alongside complex strategies to treat these lesions, may potentially render percutaneous coronary interventions in this cohort more vulnerable to failure. Prevention requires recognition and mitigation of the precipitants of stent failure, optimisation of interventional techniques, including image-guided precision percutaneous coronary intervention, and aggressive modification of a patient’s cardiovascular risk factors. Management of stent failure in the CTO population is technically challenging and itself begets recurrence. We aim to provide a comprehensive review of factors influencing stent failure in the CTO population and strategies to attenuate these.Kalaivani MahadevanClaudia CosgroveJulian W StrangeRadcliffe Medical MediaarticleSurgeryRD1-811Diseases of the circulatory (Cardiovascular) systemRC666-701ENInterventional Cardiology: Reviews, Research, Resources, Vol 16, Iss , Pp - (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Surgery RD1-811 Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Surgery RD1-811 Diseases of the circulatory (Cardiovascular) system RC666-701 Kalaivani Mahadevan Claudia Cosgrove Julian W Strange Factors Influencing Stent Failure in Chronic Total Occlusion Coronary Intervention
description	Stent failure remains one of the greatest challenges for interventional cardiologists. Despite the evolution to superior second- and third-generation drug-eluting stent designs, increasing use of intracoronary imaging and the adoption of more potent antiplatelet regimens, registries continue to demonstrate a prevalence of stent failure or target lesion revascularisation of 15–20%. Predisposition to stent failure is consistent across both chronic total occlusion (CTO) and non-CTO populations and includes patient-, lesion- and procedure-related factors. However, histological and pathophysiological properties specific to CTOs, alongside complex strategies to treat these lesions, may potentially render percutaneous coronary interventions in this cohort more vulnerable to failure. Prevention requires recognition and mitigation of the precipitants of stent failure, optimisation of interventional techniques, including image-guided precision percutaneous coronary intervention, and aggressive modification of a patient’s cardiovascular risk factors. Management of stent failure in the CTO population is technically challenging and itself begets recurrence. We aim to provide a comprehensive review of factors influencing stent failure in the CTO population and strategies to attenuate these.
format	article
author	Kalaivani Mahadevan Claudia Cosgrove Julian W Strange
author_facet	Kalaivani Mahadevan Claudia Cosgrove Julian W Strange
author_sort	Kalaivani Mahadevan
title	Factors Influencing Stent Failure in Chronic Total Occlusion Coronary Intervention
title_short	Factors Influencing Stent Failure in Chronic Total Occlusion Coronary Intervention
title_full	Factors Influencing Stent Failure in Chronic Total Occlusion Coronary Intervention
title_fullStr	Factors Influencing Stent Failure in Chronic Total Occlusion Coronary Intervention
title_full_unstemmed	Factors Influencing Stent Failure in Chronic Total Occlusion Coronary Intervention
title_sort	factors influencing stent failure in chronic total occlusion coronary intervention
publisher	Radcliffe Medical Media
publishDate	2021
url	https://doaj.org/article/6ba0aba00e714a9fad10c9441f5a0812
work_keys_str_mv	AT kalaivanimahadevan factorsinfluencingstentfailureinchronictotalocclusioncoronaryintervention AT claudiacosgrove factorsinfluencingstentfailureinchronictotalocclusioncoronaryintervention AT julianwstrange factorsinfluencingstentfailureinchronictotalocclusioncoronaryintervention
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Factors Influencing Stent Failure in Chronic Total Occlusion Coronary Intervention

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