"Utility of Intravascular Ultrasound in Percutaneous Revascularization of Chronic Total Occlusions: An Overview"

Intravascular ultrasound has been used for >20 years to guide percutaneous coronary intervention in different subsets of coronary lesions. During the last decade, the interest in percutaneous coronary intervention for chronic total occlusion (CTO) has increased dramatically, leading to high success...

JIM Today 2016 - Perspectives from the EuroCTO Club
Issue 3, February 13th, 2016

Collateral Circulation in Chronic Total Occlusions - an interventional perspective.

Human coronary collaterals are inter-coronary communications that are believed to be present from birth. In the presence of chronic total occlusions, recruitment of flow via these collateral anastomoses to the arterial segment distal to occlusion provide an alternative source of blood flow to th...

Noninvasive Discrimination of Coronary Chronic Total Occlusion and Subtotal Occlusion by Coronary Computed Tomography Angiography.

OBJECTIVES: The aim of this study was to investigate whether noninvasive discrimination of chronic total occlusion (CTO), a complete interruption of coronary artery flow, and subtotal occlusion (STO), a functional total occlusion, is feasible using coronary computed tomography angiography (CTA)....

Usefulness of the parameters of quantitative myocardial perfusion contrast echocardiography in patients with chronic total occlusion and collateral flow.

BACKGROUND: Microvascular obstruction becomes more severe with longer duration of ischemia, such as chronic total occlusion (CTO) which used to have collateral flow. In this study, we explored the correlation between parameters measured using quantitative myocardial perfusion contrast echocardio...

Extracellular volume fraction in coronary chronic total occlusion patients.

To assess extracellular volume fraction (ECV) and regional systolic function in patients presenting with coronary chronic total occlusion (CTO) in areas without significant late gadolinium enhancement (LGE), and (2) to investigate the correlation between angiography collateral flow and ECV in te...

Predicting successful percutaneous coronary intervention in patients with chronic total occlusion: the incremental value of a novel morphological parameter assessed by computed tomography.

To study the relationship between percutaneous coronary intervention (PCI) success and various morphological index evaluated by coronary computed tomography angiography (CCTA) in patients with coronary chronic total occlusion (CTO). 272 Consecutive patients with 281 CTO lesions diagnosed by CCTA and i...

Improvement of regional and global left ventricular function in magnetic resonance imaging after recanalization of true coronary chronic total occlusions.

BACKGROUND: Successful recanalization of true chronic total occlusion (CTO) has been linked to a decrease in cardiac mortality. We evaluated the effect of CTO recanalization on LVEF and regional wall motion using paired cardiac magnetic resonance imaging (cMRI) studies.


Modified contrast microinjection technique to facilitate chronic total occlusion recanalization.

OBJECTIVES: To assess the efficacy and safety of the modified contrast microinjection technique to facilitate chronic total occlusion recanalization.

BACKGROUND: The success rate of chronic total occlusion percutaneous coronary intervention (CTO-PCI) does not exceed 90% even in the most experienced cen...

Treatment of the chronic total occlusion: a call to action for the interventional community.

There is substantial evidence that recanalization of a chronic total occlusion is beneficial; nonetheless, it is generally underutilized in clinical practice. We consider the Aesop's fable of the "Fox and the Grapes" as analogous to the current situation in interventional cardiology. The ...


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