Percutaneous coronary intervention for chronic total occlusion the hybrid approach Stéphane Rinfret, editor

Format:

Book

Contributor:

Rinfret, Stéphane, editor.

Language:

English

Subjects (All):

Coronary heart disease--Surgery.

Coronary heart disease.

Coronary heart disease--Treatment.

Transluminal angioplasty.

Therapeutic embolization.

Embolization, Therapeutic.

Medical Subjects:

Embolization, Therapeutic.

Physical Description:

1 online resource

Edition:

Second edition

Place of Publication:

[S.l.] : SPRINGER INTERNATIONAL PU, 2022.

Cham Springer [2022]

Summary:

The second edition of this essential text provides readers with a detailed guide to performing various percutaneous coronary intervention (PCI) techniques for treating coronary chronic total occlusion (CTO). PCI continues to be an effective procedure to help patients with this pathology, with high success and low complications rates. Chapters feature a step-by-step approach to relevant techniques and describe their potential pitfalls, enabling the reader to develop a thorough understanding of how to perform those procedures successfully. Details of the latest methods for angiography analysis and the management of ostial CTOs, plus heavily revised chapters on topics such as contemporary device-based antegrade dissection and the retrograde approach through septal and non-septal collateral channels ensure that this Work remains the most up-to-date reference on the subject. Percutaneous Intervention for Coronary Chronic Total Occlusion: The Hybrid Approach represents a vital reference to assist practicing and trainee interventional cardiologist in learning these techniques. Various examples are provided, with a vast selection of still images and angiographic video loops to enable the reader become confident in applying these methodologies into their day-to day clinical practice

Contents:

Intro

Foreword

Preface of the First edition

Preface of the Second edition

Contents

About the Editor

1: What Is What: Important Definitions in Chronic Total Occlusion Percutaneous Coronary Intervention

Introduction

Anatomical and Procedural Definitions

Efficacy and Safety Endpoints

Conclusion

References

2: The Histopathophysiology of Chronic Total Occlusion and Its Impact on Mode of Treatment

Mechanisms of Lesion Progression and Histologic Studies of CTO

Characteristics of the Arterial Wall

The Lesion Characteristics of CTO With or Without Prior CABG

Clinical Translation from a Pathological Point of View

Conclusions

3: Who Are Best Candidates for Chronic Total Occlusion Revascularization

Prior Evidence

EXPLORE Trial

REVASC Trial

EUROCTO Trial

DECISION-CTO Trial

Conclusions from Trials

Which Patients Are Best Candidates?

Final Remarks

4: Why, When and How to Assess Ischemia and Viability in Patients with Chronic Total Occlusions

Ischemia, Hibernation, and Viability

Why to Assess Ischemia and Viability?

Ischemia

Ischemia and Collaterals, and After Opening the CTO

Ischemia and Prognosis

Ischemia and Symptoms

Viability

When to Assess Ischemia and Viability?

Guideline Recommendations

STEMI Patients with a CTO

Stable Patients with a CTO

Case Examples

How to Assess Ischemia and Viability?

Nuclear Myocardial Perfusion Imaging

Stress Echocardiography

Stress Cardiac Magnetic Resonance Imaging

Cardiac Magnetic Resonance Imaging

Nuclear Imaging

5: How to Set Up a Chronic Total Occlusion Angioplasty Program

Developing CTO Skills

Operator Selection

Operator Training

CTO Program Built Around Two Operators

Infrastructure

Cardiac Catheterization Laboratory Volume

Cardiac Catheterization Laboratory

Cardiac Surgery Program/Extracorporeal Membrane Oxygenation (ECMO)

Nonmedical Staff

Administrative Support

Quality Control

Pre-procedure: CTO Clinic

Pre-PCI Explanation of the Plan

Post Procedure: CTO Rounds

Getting Started, the Practicalities

6: Equipment Requirement for Chronic Total Occlusion Percutaneous Coronary Intervention

Sheaths

Guide Catheters

Microcatheters

Finecross

Corsair Series

Turnpike Series

Mamba Series

Guidewires

Dissection/Reentry Equipment

Guide Catheter Extensions

Snares

Equipment for "Uncrossable-Undilatable" Lesions

Intravascular Ultrasound (IVUS)

Complication Management Equipment

7: The Hybrid Approach and Its Variations for Chronic Total Occlusion Percutaneous Coronary Intervention

Introduction and Historical Perspective

Simplifying the Complex

The Algorithms.... Combined

Who Should Do the Procedure?

Pre-procedure Coronary CT Angiography

Choosing the Initial Strategy

Antegrade Wiring

Secondary and Bailout Strategies with Primary AW Approach

Antegrade Dissection and Reentry (ADR)

The Retrograde Approach

In-Stent Chronic Total Occlusion

Switching Strategies

Ending the Procedure

8: When, Why, and How to Perform Good Angiographic Analysis Before CTO PCI

When and Why

How

CTO Angiography

CTO Angiographic Analysis

Target Vessel

CTO Characteristics

Donor Vessels

Collateral Circulation

Collateral Pathways

Interventional Collaterals

9: Specific Basic Techniques to Master in CTO PCI

Approaching the CTO Segment

Wire Manipulation Techniques in CTO

Trapping Balloon Technique

10: When, Why and How to Perform an Antegrade Approach Using a Wiring Technique

Anatomical Subsets That Favor Antegrade Wiring

Lesion Length

Proximal Cap Anatomy

In-CTO Tortuosity (andgt

45°)

Presence of Intra-CTO Calcium

Previous Procedural Failure

Other Factors

Degree of Disease in the "Distal Landing Zone"

Presence of "Interventional Collaterals"

Basic Principles of CTO PCI

Planning

Visibility

Backup Support

Use of "Over-the-Wire" Equipment

Wire Selection

Tapered Polymer-Coated Wires

Medium Weight Wires

High Gram Weight Wires

The Proximal Cap and How to Assess It

Wire Selection: Principles and Rationale

Polymer-Coated Wires

Penetration Force

Tactile Feel

Torque Transmission

Wire Shaping

Confirming Progress and Ensuring Safety

Confirming True Lumen Entry

Angiographically

Wire Feel

Advancing Equipment

Anchor Balloon

Guide Extension

Higher Support Microcatheter

Laser Atherectomy

Rotational Atherectomy

Indications and Use of Adjunctive Imaging Strategies

CTA

IVUS

When to Switch Strategy

11: When, Why, and How to Perform Wire-Based Antegrade Dissection and Reentry Technique

12: When and How to Perform Contemporary Device-Based Antegrade Dissection and Re-entry Technique

Evolution of Strategies for ADR

Primary ADR: A Step-by-Step Approach

Troubleshooting ADR Procedures and Bailout Manoeuvres

Outcomes with ADR in Contemporary Practice

13: How to Deal with Difficult Antegrade Issues

Difficult Antegrade Issues That Apply to Both AW and ADR

Ambiguous Proximal Cap

Impenetrable Cap

Uncrossable Lesion

Difficult Antegrade Issues That Are Unique to Antegrade Dissection Reentry

Crossboss Challenges

Reentry Challenges

14: Intra-occlusion Microinjection of Contrast: When, Why, and How

15: When, Why, and How to Perform the Antegrade Fenestration and Reentry Technique

Pathophysiological Bases and Development of Antegrade Fenestration and Reentry (AFR)

Procedural Description of Antegrade Fenestration and Reentry (AFR)

Real-Life Experience with Antegrade Fenestration and Reentry (AFR)

Role of Antegrade Fenestration and Reentry (AFR) in the Hybrid Algorithm

Further Developments in Antegrade Fenestration and Reentry (AFR)

16: When, Why, and How to Perform the Retrograde Approach Through Septal Collateral Channels

When to Select the Retrograde Approach: How to Analyze the Coronary Angiography

How to Set Up the Procedure

Pathways to the Distal Cap (Table 16.1)

Collateral Channels

Step-by-Step Approach

Selecting the Microcatheter, Crossing the Collateral Channel with a Wire, and the Microcatheter

Selecting the Microcatheter

Crossing a Septal CC with the Wire

Surfing from PDA to LAD: A More Difficult Task

Advancing the Microcatheter to the Distal Cap Through the Septal CC

Special Situations and Considerations

Using an Internal Mammary Artery as a Donor Artery to Septal CCs

LAD or LCX CTOs in a Dominant Left System

17: When, Why, and How to Perform the Retrograde Approach Through Epicardial and Non-septal Collateral Channels

When to Perform Retrograde CTO PCI Via Non-septal Connections? Anatomic Evaluation

Algorithms for Performing Retrograde Approach

Collateral Channel Scores

Why Performing Retrograde CTO PCI Via Non-septal CCs? Clinical Evaluation

Indication and Timing of Using Non-septal Collateral CCs

Risk-Benefit Assessment of Selecting Non-septal CCs

How to Perform Retrograde CTO PCI Via Non-septal Connections: Practical Considerations

Arterial Access

Non-septal Collateral Channel Crossing

Crossing the CTO

Externalization

Complications Related to Retrograde CTO PCI Via Non-septal Connections

Perforation of the CC When the CTO Is Crossed

Perforation of the CC When the CTO Remains Uncrossed

18: When, Why, and How to Perform the Retrograde Approach Through Patent or Occluded SVGs

CTO PCI in Post-CABG Patients

Retrograde Approach Through an SVG

Retrograde Via Diseased But Patent SVGs

Retrograde Via Occluded SVGs

Guide Extensions in SVGs

Specific Situations

Stumpless SVG Use

Retrograde Access Via Acutely or Recently Thrombosed SVG in ACS Patients

How to Deal with Acute Angle of Distal Anastomosis

Distal Anastomosis Ambiguity

Stenting Coronary Across Distal SVG Anastomosis After CTO PCI

Dealing with Anastomotic Stents in SVGs

Protecting the Graft

What To Do with the SVG Once the Native Artery CTO is Open?

Potential Complications When Using SVGs as Retrograde Conduits

Distal Embolization

SVG Perforation

Aortic Dissection

Mediastinal Bleeding/Haematoma

19: How to Cross the Occlusion Using a Retrograde Approach, How to Externalize, and How to Snare Long Wires

Retrograde Wiring

Wire Choice

Confirming Wire Position

Note on Safety in RW

Retrograde Dissection and Re-entry

Creating an Antegrade Dissection

Use of Guide Catheter Extension

Creating a Retrograde Dissection

Joining the Spaces

Use of Snare for Externalization

Principles of Snaring

How to Snare

Notes:

Includes index

Online resource; title from PDF title page (SpringerLink, viewed December 19, 2022)

References -- 5: How to Set Up a Chronic Total Occlusion Angioplasty Program -- Introduction -- Developing CTO Skills -- Operator Selection -- Operator Training -- CTO Program Built Around Two Operators -- Infrastructure -- Cardiac Catheterization Laboratory Volume -- Cardiac Catheterization Laboratory -- Cardiac Surgery Program/Extracorporeal Membrane Oxygenation (ECMO) -- Nonmedical Staff -- Administrative Support -- Quality Control -- Pre-procedure: CTO Clinic -- Pre-PCI Explanation of the Plan -- Post Procedure: CTO Rounds -- Getting Started, the Practicalities -- References

ISBN:

9783031054372

3031054377

OCLC:

1351728188

Access Restriction:

Restricted for use by site license