Retrograde recanalization of chronic coronary occlusion

Chronic coronary occlusion (сhronic total occlusion – CТO) is fixed at 1 in 5 patients who underwent cardiac catheterization. Recanalization of chronic coronary occlusions is one of the most technically difficult interventional procedures. Successful recanalization of CТO is associated with better s...

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Main Author: S.М. Furkalo
Format: Article
Language:English
Published: TOV Chetverta Khvylia 2016-11-01
Series:Кардіохірургія та інтервенційна кардіологія
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Online Access:http://csic.com.ua/images/pdf/2016/4-2016/retrograde-recanalization-chronic-coronary-occlusion.pdf
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author S.М. Furkalo
author_facet S.М. Furkalo
author_sort S.М. Furkalo
collection DOAJ
description Chronic coronary occlusion (сhronic total occlusion – CТO) is fixed at 1 in 5 patients who underwent cardiac catheterization. Recanalization of chronic coronary occlusions is one of the most technically difficult interventional procedures. Successful recanalization of CТO is associated with better survival compared to patients where the procedure of recanalization was not successful. Thus, potential candidates for retrograde recanalization of CТO are рatients after failed attempt of recanalization with clear indications and motivated to implement PCI; with refractory angina and CТO of native coronary arteries after CABG; single-vessel coronary artery disease (right coronary artery, RCA or left anterior disease, LAD) with preserved left ventricular function and preserved kidney; patients with multivessel disease and related comorbidity making coronary artery bypass surgery impossible. Since 2007, 102 retrograde recanalizations of CТO were performed with total efficiency 64.3 %. CТO interventions were most often used in LAD – 50 %, RCA – 41.7 %, and left circumflex artery, LCx – 8.3 % cases. It was a successful method in CТO cases of RCA – in 86.6 % of cases, LAD – in 66 % of patients; in case of LCx CТO recanalization was successful in only two patients. Septal collaterals with retrograde approach were used in most cases – 88 patients, epicardial collaterals – in 12 cases. coronary bypass was used for retrograde access in one case, venous bypass to the LAD – in one case as well. The efficacy of retrograde approach during last five years ranged from 60 to 80 %.
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spelling doaj-art-499c47fd38744aac9f7e58ca6e3590422025-02-02T21:02:58ZengTOV Chetverta KhvyliaКардіохірургія та інтервенційна кардіологія2305-31272016-11-014515Retrograde recanalization of chronic coronary occlusionS.М. Furkalo0National O.O. Shalimov Institute of Surgery and Transplantology NAMS of Ukraine, Kyiv, UkraineChronic coronary occlusion (сhronic total occlusion – CТO) is fixed at 1 in 5 patients who underwent cardiac catheterization. Recanalization of chronic coronary occlusions is one of the most technically difficult interventional procedures. Successful recanalization of CТO is associated with better survival compared to patients where the procedure of recanalization was not successful. Thus, potential candidates for retrograde recanalization of CТO are рatients after failed attempt of recanalization with clear indications and motivated to implement PCI; with refractory angina and CТO of native coronary arteries after CABG; single-vessel coronary artery disease (right coronary artery, RCA or left anterior disease, LAD) with preserved left ventricular function and preserved kidney; patients with multivessel disease and related comorbidity making coronary artery bypass surgery impossible. Since 2007, 102 retrograde recanalizations of CТO were performed with total efficiency 64.3 %. CТO interventions were most often used in LAD – 50 %, RCA – 41.7 %, and left circumflex artery, LCx – 8.3 % cases. It was a successful method in CТO cases of RCA – in 86.6 % of cases, LAD – in 66 % of patients; in case of LCx CТO recanalization was successful in only two patients. Septal collaterals with retrograde approach were used in most cases – 88 patients, epicardial collaterals – in 12 cases. coronary bypass was used for retrograde access in one case, venous bypass to the LAD – in one case as well. The efficacy of retrograde approach during last five years ranged from 60 to 80 %.http://csic.com.ua/images/pdf/2016/4-2016/retrograde-recanalization-chronic-coronary-occlusion.pdfprevalencecoronary heart diseasechronic coronary occlusioncoronary stentingcollateral circulation
spellingShingle S.М. Furkalo
Retrograde recanalization of chronic coronary occlusion
Кардіохірургія та інтервенційна кардіологія
prevalence
coronary heart disease
chronic coronary occlusion
coronary stenting
collateral circulation
title Retrograde recanalization of chronic coronary occlusion
title_full Retrograde recanalization of chronic coronary occlusion
title_fullStr Retrograde recanalization of chronic coronary occlusion
title_full_unstemmed Retrograde recanalization of chronic coronary occlusion
title_short Retrograde recanalization of chronic coronary occlusion
title_sort retrograde recanalization of chronic coronary occlusion
topic prevalence
coronary heart disease
chronic coronary occlusion
coronary stenting
collateral circulation
url http://csic.com.ua/images/pdf/2016/4-2016/retrograde-recanalization-chronic-coronary-occlusion.pdf
work_keys_str_mv AT smfurkalo retrograderecanalizationofchroniccoronaryocclusion