Intravascular ultrasound guided recanalization of stumpless chronic total occlusion

International Journal of Cardiology
Yongwhi ParkWee-Hyun Park

Abstract

The recanalization success rate of blunt and vague stump (stumpless) CTO lesions, especially those with a side branch arising from the occlusion, has been significantly lower than that of tapered stump CTO lesions. Intravascular ultrasound (IVUS) may be useful to identify the occlusion point and may facilitate the passage of guide-wires. We evaluated the clinical feasibility of the IVUS-guided wiring technique for stumpless CTO lesions. Thirty-one consecutive patients (7 women; mean age: 61.0 ± 8.9 years) with 32 lesions were enrolled. The IVUS catheter was introduced into the side branch and it was withdrawn from the side branch to find the entry point of the occlusion, trying to engage another stiffer guide-wire on the occlusion point with the help of real-time IVUS imaging. The left anterior descending artery was the most common target-lesion location (22 lesions [69%]). CTO lesions were successfully reopened in 26 lesions (81%). IVUS guidance allowed confident navigation of the stiff guide-wires. The entry point could not be identified in one, and full guide-wire passage was impossible in 4 with the IVUS guidance; TIMI 3 flow could not be achieved even after stent deployment in 1. Although procedure-related complications de...Continue Reading

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Citations

May 27, 2015·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Rustem DautovStéphane Rinfret
May 19, 2011·Journal of Interventional Cardiology·Paul D WilliamsDouglas G Fraser
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May 5, 2018·Journal of Interventional Cardiology·Wei-Chieh HuangTse-Min Lu
Mar 16, 2021·Journal of Cardiology Cases·Shubham Agarwal, Sanjeev Kumar Agarwal
Jun 18, 2021·Minerva Cardiology and Angiology·Simone CalcagnoRoberto Garbo

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