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Intravascular ultrasound guided wiring re-entry technique for complex chronic total occlusions
- Source :
- Journal of Interventional Cardiology. 31:572-579
- Publication Year :
- 2018
- Publisher :
- Wiley, 2018.
-
Abstract
- Background The successful recanalization rate of chronic total occlusion (CTO) lesions without retrograde collaterals available is always low. Intravascular ultrasound (IVUS) may be useful to guide the subintimal guidewire to re-enter the true lumen. We evaluated the clinical feasibility and efficacy of the IVUS-guided wiring re-entry technique for these complex CTO lesions. Methods Twenty consecutive patients (19 male, mean age: 65.3 ± 12.8 years) with both failed antegrade and retrograde approaches were enrolled. The IVUS catheter was introduced into the subintimal space to identify the entry point into the subintimal space, and guide another stiff wire to re-enter the true lumen with the adjacent side-branch or first wire as markers, or using IVUS-guided parallel wire technique. Results The entry point into the subintimal space was identified by IVUS in all cases, and the IVUS-guided wiring re-entry technique succeeded in 17 cases (85%). No procedure-related complication was noted except one case of delayed cardiac tamponade due to the wire perforation. During the mean follow-up period of 1.9 ± 1.3 years, there was no adverse cardiac event, except one patient died of the complication of cardiac transplantation. Conclusion The IVUS-guided wiringre-entry technique might be feasible and safe for the recanalization of complex CTO lesions.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Taiwan
Lumen (anatomy)
030204 cardiovascular system & hematology
Cardiac Catheters
Coronary artery disease
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Cardiac tamponade
Intravascular ultrasound
Humans
Medicine
Radiology, Nuclear Medicine and imaging
030212 general & internal medicine
Ultrasonography, Interventional
Aged
medicine.diagnostic_test
business.industry
Percutaneous coronary intervention
Middle Aged
medicine.disease
Transplantation
Catheter
Outcome and Process Assessment, Health Care
Treatment Outcome
Coronary Occlusion
Surgery, Computer-Assisted
Chronic Disease
cardiovascular system
Female
Radiology
Cardiology and Cardiovascular Medicine
Complication
business
Subjects
Details
- ISSN :
- 08964327
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Journal of Interventional Cardiology
- Accession number :
- edsair.doi.dedup.....b35816f4f2941380f84d41860da69a65
- Full Text :
- https://doi.org/10.1111/joic.12518