Publications by authors named "Artis Kalnins"
Background: Gender-specific data addressing percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) in female patients are scarce and based on small sample size studies.
Aims: We aimed to analyze gender-differences regarding in-hospital clinical outcomes after CTO-PCI.
Methods: Data from 35,449 patients enrolled in the prospective European Registry of CTOs were analyzed.
The authors developed a global chronic total occlusion crossing algorithm following 10 steps: 1) dual angiography; 2) careful angiographic review focusing on proximal cap morphology, occlusion segment, distal vessel quality, and collateral circulation; 3) approaching proximal cap ambiguity using intravascular ultrasound, retrograde, and move-the-cap techniques; 4) approaching poor distal vessel quality using the retrograde approach and bifurcation at the distal cap by use of a dual-lumen catheter and intravascular ultrasound; 5) feasibility of retrograde crossing through grafts and septal and epicardial collateral vessels; 6) antegrade wiring strategies; 7) retrograde approach; 8) changing strategy when failing to achieve progress; 9) considering performing an investment procedure if crossing attempts fail; and 10) stopping when reaching high radiation or contrast dose or in case of long procedural time, occurrence of a serious complication, operator and patient fatigue, or lack of expertise or equipment. This algorithm can improve outcomes and expand discussion, research, and collaboration.
View Article and Find Full Text PDFAims: Radiation exposure is a limiting factor for percutaneous coronary interventions (PCI) of chronic total coronary occlusion (CTO) lesions. This study was designed to analyze changes in patient radiation dose for CTO-PCI and parameters associated with radiation dose.
Methods And Results: We analyzed a cohort of 12,136 procedures performed by 23 operators between 2012 and 2017 from the European Registry of CTO-PCI.
Different scoring systems are used to stratify patients with chronic total coronary artery occlusions (CTO) according to disease complexity to predict the success of the percutaneous coronary intervention (PCI). Comparison among different CTO scoring systems and long-term outcome for patients with CTO after PCI has not been well established. The objectives of the study were to assess the ability of different disease severity scoring systems to predict, first, procedural success and, second, overall survival in patients with a successful procedure.
View Article and Find Full Text PDFArticle Synopsis
- Advances in equipment and techniques have significantly improved the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI), with seven best practice principles developed through global collaboration.
- The primary reason for performing CTO-PCI is to alleviate ischemic symptoms, and using a combination of detailed angiography and specific crossing strategies is crucial for successful procedures.
- Successful CTO-PCI relies on specialized expertise, careful lesion preparation, and the use of advanced equipment to minimize complications and enhance patient outcomes, underscoring the importance of adopting these best practices widely.
Background: A retrograde approach improves the success rate of percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs).
Objectives: The authors describe the European experience with and outcomes of retrograde PCI revascularization for coronary CTOs.
Methods: Follow-up data were collected from 1,395 patients with 1,582 CTO lesions enrolled between January 2008 and December 2012 for retrograde CTO PCI at 44 European centers.