Antithrombotic Therapy in Chronic Total Occlusion Interventions

Chronic total occlusion (CTO) recanalization is among the most complex subsets of coronary interventions. Hence, optimum peri- and post-procedural anticoagulation and antiplatelet therapy is key for the achievement of successful revascularization and reduction of major adverse cardiovascular outcome...

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Autores principales:	Iosif Xenogiannis, Charalampos Varlamos, Despoina-Rafailia Benetou, Dimitrios Alexopoulos
Formato:	article
Lenguaje:	EN
Publicado:	Radcliffe Medical Media 2021
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/cb9bf1029b9c4cc38a154776694b66bf
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spelling	oai:doaj.org-article:cb9bf1029b9c4cc38a154776694b66bf2021-12-04T16:04:34ZAntithrombotic Therapy in Chronic Total Occlusion Interventions10.15420/usc.2020.371758-390X1758-3896https://doaj.org/article/cb9bf1029b9c4cc38a154776694b66bf2021-05-01T00:00:00Zhttps://www.uscjournal.com/articleindex/usc.2020.37https://doaj.org/toc/1758-3896https://doaj.org/toc/1758-390XChronic total occlusion (CTO) recanalization is among the most complex subsets of coronary interventions. Hence, optimum peri- and post-procedural anticoagulation and antiplatelet therapy is key for the achievement of successful revascularization and reduction of major adverse cardiovascular outcomes in patients undergoing CTO percutaneous coronary intervention (PCI). Unfractionated heparin is still considered the gold standard anticoagulant because its action can be reversed by protamine administration, with bivalirudin being reserved mainly for patients with heparin-induced thrombocytopenia. However, small studies comparing unfractionated heparin with bivalirudin in CTO interventions have shown similar outcomes. Glycoprotein IIb/IIIa inhibitors should, in general, be avoided. Aspirin in combination with clopidogrel for 6–12 months is the standard post CTO PCI dual antiplatelet regimen. For the most complex cases, clopidogrel can be substituted by a more potent P2Y12 inhibitor, namely ticagrelor or prasugrel.Iosif XenogiannisCharalampos VarlamosDespoina-Rafailia BenetouDimitrios AlexopoulosRadcliffe Medical MediaarticleDiseases of the circulatory (Cardiovascular) systemRC666-701ENUS Cardiology Review , Vol 15, Iss , Pp - (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 Iosif Xenogiannis Charalampos Varlamos Despoina-Rafailia Benetou Dimitrios Alexopoulos Antithrombotic Therapy in Chronic Total Occlusion Interventions
description	Chronic total occlusion (CTO) recanalization is among the most complex subsets of coronary interventions. Hence, optimum peri- and post-procedural anticoagulation and antiplatelet therapy is key for the achievement of successful revascularization and reduction of major adverse cardiovascular outcomes in patients undergoing CTO percutaneous coronary intervention (PCI). Unfractionated heparin is still considered the gold standard anticoagulant because its action can be reversed by protamine administration, with bivalirudin being reserved mainly for patients with heparin-induced thrombocytopenia. However, small studies comparing unfractionated heparin with bivalirudin in CTO interventions have shown similar outcomes. Glycoprotein IIb/IIIa inhibitors should, in general, be avoided. Aspirin in combination with clopidogrel for 6–12 months is the standard post CTO PCI dual antiplatelet regimen. For the most complex cases, clopidogrel can be substituted by a more potent P2Y12 inhibitor, namely ticagrelor or prasugrel.
format	article
author	Iosif Xenogiannis Charalampos Varlamos Despoina-Rafailia Benetou Dimitrios Alexopoulos
author_facet	Iosif Xenogiannis Charalampos Varlamos Despoina-Rafailia Benetou Dimitrios Alexopoulos
author_sort	Iosif Xenogiannis
title	Antithrombotic Therapy in Chronic Total Occlusion Interventions
title_short	Antithrombotic Therapy in Chronic Total Occlusion Interventions
title_full	Antithrombotic Therapy in Chronic Total Occlusion Interventions
title_fullStr	Antithrombotic Therapy in Chronic Total Occlusion Interventions
title_full_unstemmed	Antithrombotic Therapy in Chronic Total Occlusion Interventions
title_sort	antithrombotic therapy in chronic total occlusion interventions
publisher	Radcliffe Medical Media
publishDate	2021
url	https://doaj.org/article/cb9bf1029b9c4cc38a154776694b66bf
work_keys_str_mv	AT iosifxenogiannis antithrombotictherapyinchronictotalocclusioninterventions AT charalamposvarlamos antithrombotictherapyinchronictotalocclusioninterventions AT despoinarafailiabenetou antithrombotictherapyinchronictotalocclusioninterventions AT dimitriosalexopoulos antithrombotictherapyinchronictotalocclusioninterventions
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Antithrombotic Therapy in Chronic Total Occlusion Interventions

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