The Impact of Calcium on Chronic Total Occlusion Management

Author:

Cosgrove Claudia1ORCID,Mahadevan Kalaivani2ORCID,Spratt James C1ORCID,McEntegart Margaret3ORCID

Affiliation:

1. St George’s University Hospitals NHS Foundation Trust, London, UK

2. Bristol Heart Institute, Bristol, UK

3. Golden Jubilee National Hospital, Glasgow, UK

Abstract

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.

Publisher

Radcliffe Group Ltd

Subject

Cardiology and Cardiovascular Medicine

Reference37 articles.

1. Wilson WM, Walsh SJ, Yan AT, et al. Hybrid approach improves success of chronic total occlusion angioplasty. Heart 2016;102:1486–93. https://doi.org/10.1136/heartjnl-2015-308891; PMID: 27164918.

2. Morino Y, Abe M, Morimoto T, et al. Predicting successful guidewire crossing through chronic total occlusion of native coronary lesions within 30 minutes: the J-CTO (Multicenter CTO Registry in Japan) score as a difficulty grading and time assessment tool. JACC Cardiovasc Interv 2011;4:213–21. https://doi.org/10.1016/j.jcin.2010.09.024; PMID: 21349461.

3. Danek BA, Karatasakis A, Karmpaliotis D, et al. Development and validation of a scoring system for predicting periprocedural complications during percutaneous coronary interventions of chronic total occlusions: the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS CTO) Complications Score. J Am Heart Assoc 2016;5:e004272. https://doi.org/10.1161/JAHA.116.004272; PMID: 27729332.

4. Szijgyarto Z, Rampat R, Werner GS, et al. Derivation and validation of a chronic total coronary occlusion intervention procedural success score from the 20,000-Patient EuroCTO registry: the EuroCTO (CASTLE) score. JACC Cardiovasc Interv 2019;12:335–42. https://doi.org/10.1016/j.jcin.2018.11.020; PMID: 30711551.

5. Maeremans J, Spratt JC, Knaapen P, et al. Towards a contemporary, comprehensive scoring system for determining technical outcomes of hybrid percutaneous chronic total occlusion treatment: the RECHARGE score. Catheter Cardiovasc Interv 2018;91:192–202. https://doi.org/10.1002/ccd.27092; PMID: 28471074.

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3