How to fix common problems encountered in CTO PCI: The expanded hybrid approach

James Sapontis; Steven P. Marso; William L. Lombardi; J. Aaron Grantham

doi:10.1007/978-3-319-21563-1_11

How to fix common problems encountered in CTO PCI: The expanded hybrid approach

James Sapontis, Steven P. Marso, William L. Lombardi, J. Aaron Grantham

Research output: Chapter in Book/Report/Conference proceeding › Chapter

2 Scopus citations

Abstract

There remains a pressing need in the interventional cardiology community to narrow the existing gap in the success rates, safety, and effi ciency of chronic total occlusion percutaneous coronary intervention (CTO-PCI) relative to non CTO-PCI. Success rates for non CTOPCI are high (>98 %). The success rates of CTO-PCI at experienced CTO-PCI centers are catching up (>90 %) but are likely much lower (50-70 %) at the vast majority of other PCI centers. Complication rates appear to be equal between CTO and non-CTO procedures at experienced CTO centers but may not be at others. CTO-PCI is associated with higher procedural time, contrast use, radiation exposure and supply cost than non CTO PCI even at experienced CTO-PCI centers. Thus, a wide variability in the CTO-PCI cases being attempted persists in large part due to these gaps. This chapter provides an overview of the new expanded hybrid approach, commonly employed by successful CTO operators.

Original language	English (US)
Title of host publication	Percutaneous Intervention for Coronary Chronic Total Occlusion
Subtitle of host publication	The Hybrid Approach
Publisher	Springer International Publishing
Pages	141-159
Number of pages	19
ISBN (Electronic)	9783319215631
ISBN (Print)	9783319215624
DOIs	https://doi.org/10.1007/978-3-319-21563-1_11
State	Published - Jan 1 2016

Keywords

Antegrade dissection reentry (ADR)
CTO cap
Dissection reentry (DR)
Guidewire escalation
Hybrid approach to CTO-PCI
Retrograde cap
Subintimal TRAnscatheter Withdrawal (STRAW) technique

ASJC Scopus subject areas

General Medicine

Access to Document

10.1007/978-3-319-21563-1_11

Cite this

@inbook{b408011f5afa4157ac739624910327d5,

title = "How to fix common problems encountered in CTO PCI: The expanded hybrid approach",

abstract = "There remains a pressing need in the interventional cardiology community to narrow the existing gap in the success rates, safety, and effi ciency of chronic total occlusion percutaneous coronary intervention (CTO-PCI) relative to non CTO-PCI. Success rates for non CTOPCI are high (>98 %). The success rates of CTO-PCI at experienced CTO-PCI centers are catching up (>90 %) but are likely much lower (50-70 %) at the vast majority of other PCI centers. Complication rates appear to be equal between CTO and non-CTO procedures at experienced CTO centers but may not be at others. CTO-PCI is associated with higher procedural time, contrast use, radiation exposure and supply cost than non CTO PCI even at experienced CTO-PCI centers. Thus, a wide variability in the CTO-PCI cases being attempted persists in large part due to these gaps. This chapter provides an overview of the new expanded hybrid approach, commonly employed by successful CTO operators.",

keywords = "Antegrade dissection reentry (ADR), CTO cap, Dissection reentry (DR), Guidewire escalation, Hybrid approach to CTO-PCI, Retrograde cap, Subintimal TRAnscatheter Withdrawal (STRAW) technique",

author = "James Sapontis and Marso, {Steven P.} and Lombardi, {William L.} and {Aaron Grantham}, J.",

note = "Publisher Copyright: {\textcopyright} Springer International Publishing Switzerland 2016.",

year = "2016",

month = jan,

day = "1",

doi = "10.1007/978-3-319-21563-1_11",

language = "English (US)",

isbn = "9783319215624",

pages = "141--159",

booktitle = "Percutaneous Intervention for Coronary Chronic Total Occlusion",

publisher = "Springer International Publishing",

}

TY - CHAP

T1 - How to fix common problems encountered in CTO PCI

T2 - The expanded hybrid approach

AU - Sapontis, James

AU - Marso, Steven P.

AU - Lombardi, William L.

AU - Aaron Grantham, J.

N1 - Publisher Copyright: © Springer International Publishing Switzerland 2016.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - There remains a pressing need in the interventional cardiology community to narrow the existing gap in the success rates, safety, and effi ciency of chronic total occlusion percutaneous coronary intervention (CTO-PCI) relative to non CTO-PCI. Success rates for non CTOPCI are high (>98 %). The success rates of CTO-PCI at experienced CTO-PCI centers are catching up (>90 %) but are likely much lower (50-70 %) at the vast majority of other PCI centers. Complication rates appear to be equal between CTO and non-CTO procedures at experienced CTO centers but may not be at others. CTO-PCI is associated with higher procedural time, contrast use, radiation exposure and supply cost than non CTO PCI even at experienced CTO-PCI centers. Thus, a wide variability in the CTO-PCI cases being attempted persists in large part due to these gaps. This chapter provides an overview of the new expanded hybrid approach, commonly employed by successful CTO operators.

AB - There remains a pressing need in the interventional cardiology community to narrow the existing gap in the success rates, safety, and effi ciency of chronic total occlusion percutaneous coronary intervention (CTO-PCI) relative to non CTO-PCI. Success rates for non CTOPCI are high (>98 %). The success rates of CTO-PCI at experienced CTO-PCI centers are catching up (>90 %) but are likely much lower (50-70 %) at the vast majority of other PCI centers. Complication rates appear to be equal between CTO and non-CTO procedures at experienced CTO centers but may not be at others. CTO-PCI is associated with higher procedural time, contrast use, radiation exposure and supply cost than non CTO PCI even at experienced CTO-PCI centers. Thus, a wide variability in the CTO-PCI cases being attempted persists in large part due to these gaps. This chapter provides an overview of the new expanded hybrid approach, commonly employed by successful CTO operators.

KW - Antegrade dissection reentry (ADR)

KW - CTO cap

KW - Dissection reentry (DR)

KW - Guidewire escalation

KW - Hybrid approach to CTO-PCI

KW - Retrograde cap

KW - Subintimal TRAnscatheter Withdrawal (STRAW) technique

UR - http://www.scopus.com/inward/record.url?scp=85030101178&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85030101178&partnerID=8YFLogxK

U2 - 10.1007/978-3-319-21563-1_11

DO - 10.1007/978-3-319-21563-1_11

M3 - Chapter

AN - SCOPUS:85030101178

SN - 9783319215624

SP - 141

EP - 159

BT - Percutaneous Intervention for Coronary Chronic Total Occlusion

PB - Springer International Publishing

ER -

How to fix common problems encountered in CTO PCI: The expanded hybrid approach

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this