Antithrombotic Therapy in Chronic Total Occlusion Interventions
Chronic total occlusion (CTO) recanalization is among the most complex subsets of coronary interventions. Hence, optimum peri- and post-procedural anticoagulation and antiplatelet therapy is key for the achievement of successful revascularization and reduction of major adverse cardiovascular outcome...
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| Format: | Article |
| Language: | English |
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Radcliffe Medical Media
2021-05-01
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| Series: | US Cardiology Review |
| Online Access: | https://www.uscjournal.com/articleindex/usc.2020.37 |
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| author | Iosif Xenogiannis Charalampos Varlamos Despoina-Rafailia Benetou Dimitrios Alexopoulos |
| author_facet | Iosif Xenogiannis Charalampos Varlamos Despoina-Rafailia Benetou Dimitrios Alexopoulos |
| author_sort | Iosif Xenogiannis |
| collection | DOAJ |
| description | Chronic total occlusion (CTO) recanalization is among the most complex subsets of coronary interventions. Hence, optimum peri- and post-procedural anticoagulation and antiplatelet therapy is key for the achievement of successful revascularization and reduction of major adverse cardiovascular outcomes in patients undergoing CTO percutaneous coronary intervention (PCI). Unfractionated heparin is still considered the gold standard anticoagulant because its action can be reversed by protamine administration, with bivalirudin being reserved mainly for patients with heparin-induced thrombocytopenia. However, small studies comparing unfractionated heparin with bivalirudin in CTO interventions have shown similar outcomes. Glycoprotein IIb/IIIa inhibitors should, in general, be avoided. Aspirin in combination with clopidogrel for 6–12 months is the standard post CTO PCI dual antiplatelet regimen. For the most complex cases, clopidogrel can be substituted by a more potent P2Y12 inhibitor, namely ticagrelor or prasugrel. |
| format | Article |
| id | doaj-art-cb9bf1029b9c4cc38a154776694b66bf |
| institution | Kabale University |
| issn | 1758-3896 1758-390X |
| language | English |
| publishDate | 2021-05-01 |
| publisher | Radcliffe Medical Media |
| record_format | Article |
| series | US Cardiology Review |
| spelling | doaj-art-cb9bf1029b9c4cc38a154776694b66bf2024-12-14T16:02:47ZengRadcliffe Medical MediaUS Cardiology Review1758-38961758-390X2021-05-011510.15420/usc.2020.37Antithrombotic Therapy in Chronic Total Occlusion InterventionsIosif Xenogiannis0Charalampos Varlamos1Despoina-Rafailia Benetou2Dimitrios Alexopoulos3Second Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, GreeceSecond Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, GreeceSecond Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, GreeceSecond Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, GreeceChronic total occlusion (CTO) recanalization is among the most complex subsets of coronary interventions. Hence, optimum peri- and post-procedural anticoagulation and antiplatelet therapy is key for the achievement of successful revascularization and reduction of major adverse cardiovascular outcomes in patients undergoing CTO percutaneous coronary intervention (PCI). Unfractionated heparin is still considered the gold standard anticoagulant because its action can be reversed by protamine administration, with bivalirudin being reserved mainly for patients with heparin-induced thrombocytopenia. However, small studies comparing unfractionated heparin with bivalirudin in CTO interventions have shown similar outcomes. Glycoprotein IIb/IIIa inhibitors should, in general, be avoided. Aspirin in combination with clopidogrel for 6–12 months is the standard post CTO PCI dual antiplatelet regimen. For the most complex cases, clopidogrel can be substituted by a more potent P2Y12 inhibitor, namely ticagrelor or prasugrel.https://www.uscjournal.com/articleindex/usc.2020.37 |
| spellingShingle | Iosif Xenogiannis Charalampos Varlamos Despoina-Rafailia Benetou Dimitrios Alexopoulos Antithrombotic Therapy in Chronic Total Occlusion Interventions US Cardiology Review |
| title | Antithrombotic Therapy in Chronic Total Occlusion Interventions |
| title_full | Antithrombotic Therapy in Chronic Total Occlusion Interventions |
| title_fullStr | Antithrombotic Therapy in Chronic Total Occlusion Interventions |
| title_full_unstemmed | Antithrombotic Therapy in Chronic Total Occlusion Interventions |
| title_short | Antithrombotic Therapy in Chronic Total Occlusion Interventions |
| title_sort | antithrombotic therapy in chronic total occlusion interventions |
| url | https://www.uscjournal.com/articleindex/usc.2020.37 |
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