Prevalence, indications and management of balloon uncrossable chronic total occlusions Insights from a contemporary multicenter US registry /

BackgroundBalloon uncrossable lesions can be challenging to treat, requiring specialized techniques and equipment. MethodsWe examined the prevalence, clinical and angiographic characteristics, management and procedural outcomes of balloon uncrossable lesions in a multicenter chronic total occlusion...

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Elmentve itt :
Bibliográfiai részletek
Szerzők: Karácsonyi Judit
Karmpaliotis Dimitri
Alaswad Khaldoon
Jaffer Farouc A.
Yeh Robert W.
Patel Mitul
Bahadorani John
Doing Anthony H.
Ali Ziad A.
Karatasakis Aris
Danek Barbara A.
Rangan Bavana V.
Alame Aya J.
Banerjee Subhash
Brilakis Emmanouil S.
Dokumentumtípus: Cikk
Megjelent: 2017
Sorozat:CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS 90 No. 1
doi:10.1002/ccd.26780

mtmt:3336949
Online Access:http://publicatio.bibl.u-szeged.hu/17000
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245 1 0 |a Prevalence, indications and management of balloon uncrossable chronic total occlusions  |h [elektronikus dokumentum] :  |b Insights from a contemporary multicenter US registry /  |c  Karácsonyi Judit 
260 |c 2017 
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490 0 |a CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS  |v 90 No. 1 
520 3 |a BackgroundBalloon uncrossable lesions can be challenging to treat, requiring specialized techniques and equipment. MethodsWe examined the prevalence, clinical and angiographic characteristics, management and procedural outcomes of balloon uncrossable lesions in a multicenter chronic total occlusion (CTO) percutaneous coronary intervention (PCI) registry. ResultsBetween 2012 and 2016, 718 CTO PCIs (in which the occlusion was successfully crossed with a guidewire) were performed in 701 patients at 11 US centers. Mean age was 65.610 years and 84% of the patients were men. Balloon uncrossable lesions represented 9% of all CTOs. Balloon uncrossable CTOs had more moderate/severe calcification (82% vs. 52%, P<0.0001), moderate/severe tortuosity (61% vs. 35% P<0.0001) and higher J-CTO score (2.95 +/- 1.32 vs. 2.43 +/- 1.23, P=0.005) as compared with the remaining lesions. Technical and procedural success was significantly lower for balloon uncrossable lesions (90.5% vs. 98.3%, P<0.0001 and 88.9% vs. 96.6% P=0.004), respectively, but the incidence of major adverse events was similar (1.6% vs. 2.2%, P=0.751). Balloon uncrossable lesions required longer procedure (208 [interquartile range: 135, 258] vs. 135 [94, 194] min, P<0.0001) and fluoroscopy (77 [52, 100] vs. 45 min [27, 75], P<0.0001) time. Techniques used to treat balloon uncrossable lesions included balloon-assisted microdissection (23%), excimer laser atherectomy (18%), and rotational atherectomy (16%). Excimer laser atherectomy and balloon-assisted microdissection were associated with the highest technical and procedural success rates. ConclusionsBalloon uncrossable CTOs are common, are associated with high rates of technical failure, and require specialized techniques for successful treatment. (c) 2016 Wiley Periodicals, Inc. 
700 0 1 |a Karmpaliotis Dimitri  |e aut 
700 0 1 |a Alaswad Khaldoon  |e aut 
700 0 1 |a Jaffer Farouc A.  |e aut 
700 0 1 |a Yeh Robert W.  |e aut 
700 0 1 |a Patel Mitul  |e aut 
700 0 1 |a Bahadorani John  |e aut 
700 0 1 |a Doing Anthony H.  |e aut 
700 0 1 |a Ali Ziad A.  |e aut 
700 0 1 |a Karatasakis Aris  |e aut 
700 0 1 |a Danek Barbara A.  |e aut 
700 0 1 |a Rangan Bavana V.  |e aut 
700 0 1 |a Alame Aya J.  |e aut 
700 0 1 |a Banerjee Subhash  |e aut 
700 0 1 |a Brilakis Emmanouil S.  |e aut 
856 4 0 |u http://publicatio.bibl.u-szeged.hu/17000/1/2017_Prevalence_Indications_CCI.pdf  |z Dokumentum-elérés