Chronic Total Occlusions

Chronic Total Occlusions (CTO) are complete obstructions or blockages of an artery that can lead to worsening conditions. Catheterization procedures are useful in the detection and treatment of CTO, and Cath Lab Digest contains numerous articles on the topic. Feel free to browse through the information below.

Crossing Chronic Total Occlusions Cath Lab Digest talks with? Raj Dave, MD, Director, Endovascular Medicine, Pinnacle Health/Harrisburg Hospital, Harrisburg, Pennsylvania and Jeffrey W. Moses, MD, Professor of Medicine at Columbia University Medical Center (CUMC); Director of the Center for Interventional Vascular Therapy (CIVT) at CUMC; Director, Cardiac Catheterization Lab, New York-Presbyterian Hospital/CUMC New York, New York

Treating CTOs: Technique and technology Can you describe the interventional program at St. Luke?s? We have a large subspecialty group practice with eight cardiac cath labs, three of which are dedicated to percutaneous intervention. We perform about 2000?2250 stenting procedures/year.

Successful Use of a New Guidewire with Radiofrequency Ablation Capability for the Treatment of Chronic Total Occlusion at the Ostium of the Left Anterior Descending Artery Successful Use of a New Guidewire with Radiofrequency Ablation Capability for the Treatment of Chronic Total Occlusion at the Ostium of the Left Anterior Descending Artery Feature: Successful Use of a New Guidewire with Radiofrequency Ablation Capability for the Treatment of Chronic Total Occlusion at the Ostium of the Left Anterior Descending Artery - Angela Hoye MB ChB, MRCP, Pedro A. Lemos MD, Patrick W. Serruys MD, PhD The major limitation of percutaneous therapy (PCI) for the treatment ...

The Frontrunner? CTO Catheter Experience It is estimated that about every third patient undergoing coronary angiography presents at least one total coronary artery occlusion.1,2 Chronic Total Occlusions (CTO), defined as an occlusion greater than three months old with TIMI 0 Flow, continue to rank among the most significant obstacles to complete coronary revascularization via percutaneous methods. Recently published studies have illustrated that by crossing a CTO and subsequently recanalizing a total occluded artery, long-term patient survival is improved. Suero et al recently published a 10-year retrospective study of 2,007 CTO patients showing a distinct ten year survival advantage for successful CTO treatment compared to failed CTO treatment (73.5% vs. 65.1%, p=0.001).3

Mid-RCA Chronic Total Occlusion Recanalized with CROSSER? Catheter as First Therapy Case History. A 54-year-old patient underwent cardiac catheterization following a positive exercise stress test in April of 2006.

Crosser? Catheter used Primarily to Treat Proximal LAD Chronic Total Occlusion Case History A 61-year-old male with no history of infarct, percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG) presented with stable CCS II angina.

Advances in Guidewire Technology I had used a fair amount of Guidant wires prior to this and a fair amount of Boston Scientific wires, but made a real conversion on the majority of my cases to Asahi wires. s hydrophilic wire across the lesion, so I tried a Prowater, which is one of the AVD Asahi hydrophilic wires. Chronic occlusion wires still need some work, though the Asahi specialty wires have been a welcome addition.

Research Update 462) Chronic Total Occlusions A New Percutaneous Porcine Coronary Model of Chronic Total Occlusion Authors: Woohyuk Song, Jaeung Lee, Hyunjoong Kim, Jinho Shin, Dongjoo Oh, Fermin Tio, S. Chiu Wong, Mun K. Hong Objective: Chronic total occlusion (CTO) of coronary arteries represents a challenge for percutaneous treatment. Embolic Protection Device Performance Evaluation in the Carotid Artery During Percutaneous Transluminal Angioplasty and/or Stenting Author: Alberto Cremonesi Recently ...

Laser Atherectomy in Peripheral Arterial Disease Can you discuss how laser atherectomy has evolved and overcome some of its initial challenges? Laser technology, as well as the catheter design, has evolved over a period of years to make the device safer and more effective. Early laser systems actually utilized a hot tip laser, which heated the tip of the catheter and also used a variety of wavelengths. Initial laser systems were not very successful. They caused damage to the arterial wall and were unable to penetrate especially difficult tissue. The early use of excimer laser was in late 1980s, when the catheter design was stiff and caused more perforation.

Conquering Chronic Total Coronary Occlusions: Penetrating the Frontier The chronic total occlusion (CTO) is one of the final barriers to complete revascularization using percutaneous coronary techniques. For many years, numerous investigators have attempted to improve on outcomes of opening CTOs, the success of which has ranged from 50?75% even in the best of hands. In this issue of Cath Lab Digest, the state-of-the-art for CTO revascularization is reviewed.