Chronic Total Occlusion Crossing Approach Based on Plaque Cap Morphology: The CTOP Classification

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
Fadi SaabJ A Mustapha

Abstract

To present the chronic total occlusion (CTO) crossing approach based on plaque cap morphology (CTOP) classification system and assess its ability to predict successful lesion crossing. A retrospective analysis was conducted of imaging and procedure data from 114 consecutive symptomatic patients (mean age 69±11 years; 84 men) with claudication (Rutherford category 3) or critical limb ischemia (Rutherford category 4-6) who underwent endovascular interventions for 142 CTOs. CTO cap morphology was determined from a review of angiography and duplex ultrasonography and classified into 4 types (I, II, III, or IV) based on the concave or convex shape of the proximal and distal caps. Statistically significant differences among groups were found in patients with rest pain, lesion length, and severe calcification. CTOP type II CTOs were most common and type III lesions the least common. Type I CTOs were most likely to be crossed antegrade and had a lower incidence of severe calcification. Type IV lesions were more likely to be crossed retrograde from a tibiopedal approach. CTOP type IV was least likely to be crossed in an antegrade fashion. Access conversion, or need for an alternate access, was commonly seen in types II, III, and IV lesi...Continue Reading

References

Aug 16, 2003·BMJ : British Medical Journal·Daniel HindSteven Thomas
Jan 11, 2005·Journal of Vascular and Interventional Radiology : JVIR·David J SpinosaAlan H Matsumoto
Oct 9, 2008·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Miguel Montero-BakerDierk Scheinert
Jul 25, 2009·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Mazen S Abu-FadelThomas A Hennebry
Sep 21, 2010·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·R Kevin RogersIvan P Casserly
Nov 12, 2013·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·J A MustaphaBarbara Karenko
Jun 23, 2016·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Trisha RoyGraham A Wright
Aug 26, 2016·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Craig M WalkerGeorge L Adams
May 2, 2017·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Jan Peter GoltzErik Stahlberg

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Citations

Mar 27, 2018·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Rutger H A WellingAndrej Schmidt
Apr 11, 2018·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·George A Pliagas
Jun 16, 2018·The Journal of Cardiovascular Surgery·Ansar Z VanceTimothy W Clark
Dec 14, 2019·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Jihad A MustaphaLarry J Diaz-Sandoval
Jan 7, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Damianos G KokkinidisEhrin J Armstrong
Mar 12, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·John G Winscott, William B Hillegass
Jun 27, 2019·The Journal of Cardiovascular Surgery·Konstantinos StavroulakisBella Huasen
Nov 20, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·John R LairdUNKNOWN Wing-It Trial Investigators
Dec 29, 2020·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·Stefanos GiannopoulosEhrin J Armstrong
Feb 7, 2021·Journal of Vascular Surgery·Richard B Allan, Christopher L Delaney
Apr 6, 2021·Annals of Vascular Surgery·Zachary F WilliamsMitchell W Cox
May 12, 2021·Cirugía española·Malka Huici-SanchezRamón Vila-Coll
Oct 7, 2021·Journal of the American Heart Association·J Antonio Gutierrez, Manesh R Patel

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