Table of Contents:
Dedication
List of Contributors
Foreword
1. CTO Interventions: Definition, Prevalence, Indications, Guidelines
1.1 CTO Definition
1.2 Prevalence of CTOs
1.3 Indications and Potential Clinical Benefits of CTO PCI
1.4 Guidelines for CTO PCI
1.5 Appropriateness Use Criteria in CTO PCI
1.6 Contraindications to CTO PCI
1.7 Summary and Conclusions
References
2. Equipment
2.1 Sheaths
2.2 Guide Catheters
2.3 Microcatheters
2.4 Guidewires
2.5 Dissection/Re-Entry Equipment
2.6 Snares
2.7 “Uncrossable-Undilatable” Lesion Equipment
2.8 Intravascular Ultrasound
2.9 Complication Management Equipment
2.10 Radiation Protection
2.11 The “CTO cart”
References
3. The Basics: Timing, Dual Injection, Studying the Lesion, Access, Anticoagulation, Guide Support, Trapping
3.1 Timing
3.2 Dual Injection
3.3 Studying the Lesion
3.4 Vascular Access
3.5 Anticoagulation
3.6 Techniques to Increase Guide Catheter Support (Large Bore Guide, Active Guide Support, Guide Catheter Extensions, Anchor Techniques
3.7 Trapping
References
4. Antegrade Wire Escalation: The Foundation of CTO PCI
4.1 Special Situations
References
5. Antegrade Dissection/Re-entry
5.1 Knuckle Wire
5.2 CrossBoss
5.3 Stingray-Based Re-entry
5.4 Wire-Based Re-entry
References
6. The Retrograde Approach
6.1 Historical Perspective
6.2 Advantages of the Retrograde Approach
6.3 Special Equipment
6.4 Step-by-Step Description of the Procedure
6.5 Retrograde True Lumen Puncture
6.6 Retrograde Dissection/Re-entry
6.7 Antegrade Crossing
6.8 Special Retrograde CTO PCI Scenarios
References
7. Putting it all Together: The “Hybrid” Approach
7.1 Description of the “Hybrid” Algorithm
7.2 Impact of the “Hybrid” Approach
References
8. “Balloon Uncrossable” CTOs
8.1 Simultaneous Use of Strategies
References
9. “Balloon Undilatable” CTOs
9.1 Special Case Scenario: Stented “Balloon Undilatable” Lesions
References
10. Radiation Management During CTO PCI
10.1 Why is Radiation Management Important?
10.2 Essentials of Radiation Dose Management
10.3 Conclusions
References
11. Stenting of CTO Lesions
11.1 Stent Type
11.2 Stent Optimization
11.3 Antiplatelet Therapy After CTO Stenting
References
12. Complications
12.1 Acute Complications
12.2 Long-Term Complications
12.3 Conclusion
References
13. How to Build a Successful CTO Program
References
Appendix 1. Equipment Commonly Utilized in CTO Interventions
Appendix 2. Commonly Used Acronyms in CTO Interventions
Index
