Antegrade Chronic Total Occlusion Strategies: A Technical Focus for 2020

Chronic total occlusions (CTOs) are common in patients with ischaemic heart disease. In many countries, patients with CTOs are underserved by percutaneous coronary intervention (PCI). One of the barriers to CTO PCI is the technical challenges of these procedures. Improvements in technique and dedica...

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Autores principales:	Calum Creaney, Simon J Walsh
Formato:	article
Lenguaje:	EN
Publicado:	Radcliffe Medical Media 2020
Materias:	Surgery RD1-811 Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/86768e36b9fa448eba658d3a879108d9
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spelling	oai:doaj.org-article:86768e36b9fa448eba658d3a879108d92021-12-04T16:03:15ZAntegrade Chronic Total Occlusion Strategies: A Technical Focus for 202010.15420/icr.2020.051756-14851756-1477https://doaj.org/article/86768e36b9fa448eba658d3a879108d92020-06-01T00:00:00Zhttps://www.icrjournal.com/articleindex/icr.2020.05https://doaj.org/toc/1756-1477https://doaj.org/toc/1756-1485Chronic total occlusions (CTOs) are common in patients with ischaemic heart disease. In many countries, patients with CTOs are underserved by percutaneous coronary intervention (PCI). One of the barriers to CTO PCI is the technical challenges of these procedures. Improvements in technique and dedicated devices for CTO PCI, combined with advances in procedural strategy, have resulted in a dramatic increase in procedural success and outcomes. Antegrade wiring (AW) is the preferred initial strategy in short CTOs, where the proximal cap and course of the vessel is understood. For many longer, more complex occlusions, AW has a low probability of success. Dissection and re-entry techniques allow longer CTOs and those with ambiguous anatomy to be crossed safely and efficiently, and CTO operators must also be familiar with these strategies. The CrossBoss and Stingray system is currently the primary targeted re-entry device used during antegrade dissection and re-entry (ADR), and there continues to be an evolution in its use to increase procedural efficiency. In contrast to older ADR techniques, targeted re-entry allows preservation of important side-branches, and there is no difference in outcomes compared to intraplaque stenting.Calum CreaneySimon J WalshRadcliffe Medical MediaarticleSurgeryRD1-811Diseases of the circulatory (Cardiovascular) systemRC666-701ENInterventional Cardiology: Reviews, Research, Resources, Vol 15, Iss , Pp - (2020)
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 Calum Creaney Simon J Walsh Antegrade Chronic Total Occlusion Strategies: A Technical Focus for 2020
description	Chronic total occlusions (CTOs) are common in patients with ischaemic heart disease. In many countries, patients with CTOs are underserved by percutaneous coronary intervention (PCI). One of the barriers to CTO PCI is the technical challenges of these procedures. Improvements in technique and dedicated devices for CTO PCI, combined with advances in procedural strategy, have resulted in a dramatic increase in procedural success and outcomes. Antegrade wiring (AW) is the preferred initial strategy in short CTOs, where the proximal cap and course of the vessel is understood. For many longer, more complex occlusions, AW has a low probability of success. Dissection and re-entry techniques allow longer CTOs and those with ambiguous anatomy to be crossed safely and efficiently, and CTO operators must also be familiar with these strategies. The CrossBoss and Stingray system is currently the primary targeted re-entry device used during antegrade dissection and re-entry (ADR), and there continues to be an evolution in its use to increase procedural efficiency. In contrast to older ADR techniques, targeted re-entry allows preservation of important side-branches, and there is no difference in outcomes compared to intraplaque stenting.
format	article
author	Calum Creaney Simon J Walsh
author_facet	Calum Creaney Simon J Walsh
author_sort	Calum Creaney
title	Antegrade Chronic Total Occlusion Strategies: A Technical Focus for 2020
title_short	Antegrade Chronic Total Occlusion Strategies: A Technical Focus for 2020
title_full	Antegrade Chronic Total Occlusion Strategies: A Technical Focus for 2020
title_fullStr	Antegrade Chronic Total Occlusion Strategies: A Technical Focus for 2020
title_full_unstemmed	Antegrade Chronic Total Occlusion Strategies: A Technical Focus for 2020
title_sort	antegrade chronic total occlusion strategies: a technical focus for 2020
publisher	Radcliffe Medical Media
publishDate	2020
url	https://doaj.org/article/86768e36b9fa448eba658d3a879108d9
work_keys_str_mv	AT calumcreaney antegradechronictotalocclusionstrategiesatechnicalfocusfor2020 AT simonjwalsh antegradechronictotalocclusionstrategiesatechnicalfocusfor2020
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Antegrade Chronic Total Occlusion Strategies: A Technical Focus for 2020

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