Percutaneous coronary interventions (PCI) for chronic total occlusions (CTO) are the most challenging type of procedure in interventional cardiology and are traditionally associated with increased complexity and reduced procedural success rates. New techniques, such as retrograde approach and dissection reentry technique, offer alternatives in case of traditional antegrade wiring failure. In this paper, we present a successful implantation of a stent parallel to other existing stent in an in-stent CTO (IS-CTO) using dissection reentry technique. The technical details involved and the clues to successful outcome in an individual with in-stent CTO are discussed.
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http://dx.doi.org/10.1055/s-0038-1661375 | DOI Listing |
Indian J Thorac Cardiovasc Surg
February 2025
Department of Paediatric and Congenital Heart Surgery, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Rao Saheb, Achutrao Patwardhan Marg, Four Bungalows, Andheri West, Mumbai, Maharashtra 400053 India.
Unlabelled: In congenital heart surgery, redo-sternotomies are very common. In most cases, sternal re-entry is achieved without serious complications. However, sometimes elective institution of peripheral cardiopulmonary bypass is needed for safe sternotomy, albeit with a long cardio-pulmonary bypass time.
View Article and Find Full Text PDFJ Soc Cardiovasc Angiogr Interv
December 2024
Department of Cardiology, HonorHealth/Scottsdale Shea Medical Center, Scottsdale, Arizona.
Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is high risk compared to non-CTO PCI. Iatrogenic coronary artery hematoma formation is a common occurrence during CTO PCI, impairing true lumen visualization. We describe the use of a continuous mechanical suction (CMS) device in 2 applications in which it was used for successful subintimal hematoma decompression and distal vessel re-entry.
View Article and Find Full Text PDFKyobu Geka
December 2024
Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.
A 61-year-old female underwent ascending aortic replacement (resecting the primary entry in the ascending aorta) for Stanford type A acute aortic dissection 1 year and 8 months before. Her postoperative course was uneventful, and the patient was discharged on 17 days later. Follow-up recent computed tomography (CT) scans, however, revealed dissecting aortic aneurysm of the distal aortic arch due to a new entry at the distal anastomosis of the ascending replacement.
View Article and Find Full Text PDFEur Heart J Case Rep
December 2024
Department of Cardiac Surgery, The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing 400030, China.
Background: Few studies have investigated the effect of the intimal morphology of type B aortic dissection (TBAD) on the blood flow after rupture. We report a case of a 30-year-old male with complicated TBAD, who underwent assessment with 4D computed tomography (4D-CT).
Case Summary: Patient presented with chest tightness for 14 days, a heart rate of 67 b.
Catheter Cardiovasc Interv
January 2025
Department of Internal Medicin and Cardiology, Heartcenter Lahr, Lahr, Germany.
Background: The parallel wire technique (PW) is a classic part of the antegrade strategy to open chronic total coronary occlusions (CTO).
Aims: With modern wires and dual-lumen catheters (DLC) the approach has evolved, but this progress had not been evaluated in a contemporary registry of CTO interventions.
Method: This analysis is based on 26,589 CTO procedures performed by 36 operators with > 50 procedures annually between 2015 and 2022.
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