Collateral Channel Size and Tortuosity Predict Retrograde Percutaneous Coronary Intervention Success for Chronic Total Occlusion.

Circ Cardiovasc Interv

From the Department of Internal Medicine, National Taiwan University Hospital, Taipei (C.-C.H., C.-S.H., Y.-H.C., M.-S.L., C.-F.Y., H.-L.K.); and Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu (C.-K. L., S.-W.M.).

Published: January 2018

Background: There is little evidence on how to select an interventional collateral channel (CC) in retrograde chronic total occlusion (CTO) percutaneous coronary intervention. We aimed to identify independent angiographic predictors of CC tracking and technical success in retrograde CTO percutaneous coronary intervention.

Methods And Results: From January 2012 to December 2015, a total of 216 consecutive retrograde CTO percutaneous coronary intervention attempts by a high-volume operator in a tertiary university-affiliated hospital were enrolled. The clinical, angiographic, and procedural details were collected. The characteristics analyzed included channel type, size, tortuosity, angle of attack, length to emerging point, and the Multicenter CTO Registry of Japan score. The Multicenter CTO Registry of Japan score was 4.2±0.8. A total of 242 CCs were attempted for intervention. CC tracking success rate was 83.5%, and the technical success rate (per CC) was 81.4%. The per-patient technical success rate was 91.2%, and the major procedural complication rate was 4.6%. The atrioventricular groove, epicardial, and septal CCs were used in 36 (14.9%), 84 (34.7%), and 122 (50.4%) tracking attempts, respectively. In multivariable analysis, only large channel size and lack of tortuosity were significant independent predictors of CC tracking and technical success. A new scoring system was developed, while large size was given 1 point and lack of tortuosity was given 2 points. The receiver-operating characteristic area by the new model to predict CC tracking and technical success were 0.800 and 0.752, respectively.

Conclusions: In retrograde CTO percutaneous coronary intervention, only size and tortuosity of a CC are independent angiographic predictors of CC tracking and technical success.

Download full-text PDF

Source
http://dx.doi.org/10.1161/CIRCINTERVENTIONS.117.005124DOI Listing

Publication Analysis

Top Keywords

technical success
24
percutaneous coronary
20
coronary intervention
16
cto percutaneous
16
tracking technical
16
size tortuosity
12
predictors tracking
12
retrograde cto
12
success rate
12
collateral channel
8

Similar Publications

Background: Mobile health apps have shown promising results in improving self-management of several chronic diseases in patients. We have developed a mobile health app (Cardiomeds) dedicated to patients with heart failure (HF). This app includes an interactive medication list; daily self-monitoring of symptoms, weight, blood pressure, and heart rate; and educational information on HF delivered through various formats.

View Article and Find Full Text PDF

Purpose: The purpose of this study was to explore the therapeutic potential of the novel combination of Bacillus bacteriophage lysin (PlyB) and a synthetic TLR2/4 inhibitor (oxidized 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphocholine, OxPAPC) in the treatment of experimental Bacillus cereus endophthalmitis.

Methods: C57BL/6J mice were injected with 100 colony forming units (CFUs) Bacillus cereus to induce endophthalmitis. Two hours postinfection, groups of mice were treated with either PlyB, PlyB with OxPAPC, or the groups were left untreated to serve as a control.

View Article and Find Full Text PDF

Introduction: Results from randomized controlled trials of upadacitinib, a Janus kinase (JAK) inhibitor, have led to its approval for the treatment of moderate-to-severe atopic dermatitis (AD) in patients aged ≥ 12 years. The aim of this study was to report the effectiveness and safety of upadacitinib in real-world settings over a period of 96 weeks.

Methods: This retrospective study included all patients treated with upadacitinib at our centre between April 2022 and September 2024.

View Article and Find Full Text PDF

Background: Bariatric surgeries, such as laparoscopic sleeve gastrectomy (LSG), not only result in significant weight loss but also improve the inflammatory state in obese patients. This study aimed to investigate the effects of LSG on weight loss and inflammation status in bariatric patients 1-year post-procedure.

Methods: This prospective cohort study was conducted from September 2022 to May 2024.

View Article and Find Full Text PDF

CXR-LLaVA: a multimodal large language model for interpreting chest X-ray images.

Eur Radiol

January 2025

Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

Objective: This study aimed to develop an open-source multimodal large language model (CXR-LLaVA) for interpreting chest X-ray images (CXRs), leveraging recent advances in large language models (LLMs) to potentially replicate the image interpretation skills of human radiologists.

Materials And Methods: For training, we collected 592,580 publicly available CXRs, of which 374,881 had labels for certain radiographic abnormalities (Dataset 1) and 217,699 provided free-text radiology reports (Dataset 2). After pre-training a vision transformer with Dataset 1, we integrated it with an LLM influenced by the LLaVA network.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!