Chronic Total Occlusions

"Chronic total occlusions continue to represent one of the greatest challenges to interventional cardiologists." - Cardiovascular Research Foundation - Chronic Total Occlusions or CTOs can be found in 30% of patients with coronary artery disease. Despite advances, CTOs remain one of the most frequently identified lesions in interventional cardiology yet least likely to be successfully treated. The prevalence of the disorder is vexing. The threat to your patients is significant. The condition is complex. And, treatment remains a challenge. Learn how to approach CTOs from internationally-recognized physician-educators Turn to Chronic Total Occlusions: A Guide to Recanalization, 2e for expert insight into the world of CTOs and clear, practical guidance you can apply directly and immediately in your cath lab. Offering the most comprehensive information available, this completely updated second edition provides you wih: Full-color images from the diagnostic modalities that are essential in identifying CTOs Data on indications and efficacy from the most recent clinical trials Practical guidance on the selection and use of the latest wires and devices Even more tips and tricks from leading operators from the world’s busiest centers Clinical cases to illustrate some of the more complex scenarios and common complications And more! Chronic Total Occlusions: A Guide to Recanalization, 2e is the guide you can count on to improve the CTO success rate at your facility. CONTENTS Part I Pathology, Indications, and Review of Clinical Trials 1 The pathobiology of CTO, 3 Sergey Yalonetsky, Azriel B. Osherov & Bradley H. Strauss 2 Collateral circulation in CTO, 9 Alfredo R. Galassi, S.D. Tomasello & Hazem Khamis 3 CTO: review of trials, 18 Tina L. Pinto Slottow & Ron Waksman 4 CTO-percutaneous coronary intervention: what is the evidence?, 26 Gabriel Maluenda, Tina L. Pinto Slottow & Ron Waksman 5 Case selection and long-term benefits, 33 Imran N. Ahmad, Kamran I. Muhammad & Patrick L. Whitlow Part II Imaging 6 CT angiography: application in chronic total occlusions, 45 Hidehiko Hara, John R. Lesser, Nicholas Burke & Robert S. Schwartz 7 Co-registration CTO and CT angiography, 51 Gary M. Idelchik & Ariel Roguin 8 Optical coherence tomography to guide the treatment of chronic total occlusions, 60 Nicola Viceconte, Rodrigo Teijeiro-Mestre, Nicolas Foin, Alistair C. Lindsay and Carlo Di Mario. 9 IVUS-guided CTO-PCI, 67 Masashi Kimura & Yasushi Asakura 10 IVUS evaluation of CTO, 78 Akiko Maehara, Masahiko Ochiai & Gary S. Mintz 11 Magnetic navigation wire, 85 Steve Ramcharitar & Patrick Serruys Part III Wires Technology 12 Deflecting wire systems, 93 Mirko Schiemann 13 Asahi wires, 97 Shigeru Saito 14 IVUS-guided recanalization of CTO, 105 Etsuo Tsuchikane 15 Frontrunner CTO technology, 109 Chad Kliger, Steven P. Sedlis & Jeffrey D. Lorin 16 Channel dilator: Corsair, 113 Masashi Kimura Part IV Wires Technique 17 Tornus catheter, 121 Hideaki Kaneda 18 Antegrade approach: step by step, 126 Nicolaus Reifart 19 Use of two wires in the treatment of CTO, 134 Yves Louvard, Thierry Lefèvre & Marie-Claude Morice 20 Parallel-wire techniques, 143 Sudhir Rathore & Takahiko Suzuki 21 Guidewire handling techniques for CTO lesions, 147 Shigeru Saito 22 Subintimal angioplasty in coronary CTO, 155 Philippe Généreux & George D. Dangas 23 Antegrade device assisted re-entry techniques, 162 Nicolaus Reifart 24 The microchannel technique, 166 Mauro Carlino, Gill L. Buchanan & Cosmo Godino 25 The STAR technique, 172 Cosmo Godino, Mauro Carlino & Antonio Colombo 26 Attempting CTO after first failed attempt, 178 Sudhir Rathore & Takahiko Suzuki 27 Transradial approach for CTO lesions and tapered-tip guidewires, 184 Shigeru Saito 28 Bilateral approach, 191 Osamu Katoh 29 Tips and tricks of the CART technique, 198 Osamu Katoh Part V Devices Technology 30 Recanalizing total occlusion in the periphery: utilization of radio frequency and other technology, 209 Shishir Murarka & Richard Heuser 31 High-frequency mechanical revascularization, 226 Eberhard Grube & Lutz Buellesfeld 32 Debulking of CTO, 230 Etsuo Tsuchikane 33 Vibrational angioplasty, 235 Lampros K. Michalis 34 Treatment of chronic total coronary occlusions with drug-eluting stents: overview of angiographic and clinical outcomes, 240 David E. Kandzari 35 Laser for CTO recanalization, 251 On Topaz 36 The ENABLER-P: a novel CTO crossing cystem, 257 Maurice Buchbinder 37 Collagenase plaque digestion for facilitating guidewire crossing, 262 Azriel B. Osherov & Bradley H. Strauss 38 The BridgePoint re-entry system, 268 Imran N. Ahmad, Kamran I. Muhammad & Patrick L. Whitlow Part VI Complications 39 Complications during the retrograde approach for CTO, 275 Shigeru Saito 40 CTO: how to minimize contrast nephropathy, 279 Travis J. Bench & Luis Gruberg Part VII Interesting Cases 41 Interesting cases I–VI, 291 Shigeru Saito