ライフサイエンスコーパス: CTO

1 CTO lesions attempted using RA had lower Japan-CTO score

2 CTO PCI was successful in 10,199 cases (70.6%).

3 CTO-PCI success increased with operator experience (45%

4 CTO-PCI was defined as intervention of a 100% occluded c

5 ated with drug-eluting stents for at least 1 CTO (>3 months).

6 to 3.83 years), successful PCI of at least 1 CTO was associated with improved survival (hazard ratio

7 At least 1 CTO was present in 71 (44%) patients.

8 1,035 patients underwent PCI for at least 1 CTO.

9 The Collagenase Total Occlusion-1 (CTO-1) Trial is a phase I, dose-escalation trial to asse

10 a cohort of new CTO operators performing <10 CTO PCI cases per given year.

11 METHODS AND We analyzed 1253 CTO percutaneous coronary intervention procedures perfor

12 ers of patients readmitted (100 [61%] of 165 CTOs vs 113 [68%] of 165 controls; relative risk 0.88 [9

13 nts disengaged from services (12 [7%] of 165 CTOs vs 7 [4%] of 165 controls).

14 A total of 1,253 CTO-PCIs were performed in 1,177 patients, of which 86%

15 graphic characteristics and outcomes of 3486 CTO interventions performed in patients with (n=1101) an

16 mean age of 63.5 years and underwent 14,439 CTO procedures.

17 atient and procedural characteristics of 470 CTO cases treated from January 2010 to December 2015 dep

18 tients enrolled in the registry, 7389 (3.5%) CTO-PCIs were attempted with a success rate of 53%.

19 ere collected from 1,395 patients with 1,582 CTO lesions enrolled between January 2008 and December 2

20 A total of 376 CP were recorded from 26 807 CTO-PCI interventions (incidence of 1.40%) with an incre

21 Between July 2009 and December 2015, 93 875 CTO PCI cases were extracted from the CathPCI Registry.

22 s the half of all operators who performed <9 CTO PCIs per year.

23 patients (1:1) to be discharged on either a CTO (n=167) or to voluntary status via Section 17 leave

24 Mayo Clinic registry who required PCI for a CTO.

25 007 consecutive patients underwent PCI for a CTO.

26 rted series of patients undergoing PCI for a CTO.

27 rvival for patients with successful PCI of a CTO has not been clearly defined.

28 Percutaneous coronary intervention of a CTO is a common occurrence, and the long-term survival f

29 ort to determine whether successful PCI of a CTO is associated with improved survival.

30 ment of the donor vessel in the setting of a CTO may overestimate the severity of stenosis, and that

31 atheterization laboratory, the presence of a CTO provides a unique and specific situation whereby the

32 Broadly, the physiological assessment of a CTO relies on assessing the function and regression of c

33 Recanalization of a CTO results in a modest increase in the FFR of the predo

34 oing percutaneous coronary intervention of a CTO, coronary pressure and flow velocity were measured a

35 nosis, and that after revascularization of a CTO, the index of ischemia may increase, potentially alt

36 with successful versus unsuccessful PCI to a CTO.

37 physiological assessment of patients with a CTO, management recommendations and identify areas for o

38 Additional CTO PCI within 1 week after primary PCI for STEMI was fe

39 es of AAM escalation and de-escalation after CTO PCI.

40 ether the recovery of anterograde flow after CTO recanalization with drug-eluting stent implantation

41 degree of quality of life improvement after CTO PCI in patients with refractory angina.

42 pnea reported less dyspnea improvement after CTO PCI.

43 TOs) and predictors of its improvement after CTO percutaneous coronary intervention (PCI) are unknown

44 iation in postprocedure AAM management after CTO PCI across hospitals have not been reported.

45 Dyspnea Scale at baseline and 1 month after CTO PCI.

46 , 70% reported less dyspnea at 1 month after CTO PCI.

47 essed AAM use at baseline and 6 months after CTO PCI.

48 low reserve, and perfusion defect size after CTO percutaneous coronary intervention was comparable be

49 nts who may benefit from AAM titration after CTO PCI and develop strategies to adjust these medicatio

50 is severe impairment of vasomotor tone after CTO reopening suggests that intracoronary ultrasound ass

51 (p < 0.001) or media (p = 0.0001) across all CTO ages.

52 Central Cardiac Audit Database for all CTO PCI cases carried out in England and Wales between J

53 ascular Intervention Society data set on all CTO-PCI procedures performed in England and Wales betwee

54 had complete revascularization (CR) for all CTOs and other diseased lesions.

55 ention was done in 30% of patients, although CTO lesions were attempted in only 10% (with 70% success

56 e analyzed patients with concomitant ULM and CTO-RCA, cardiac-death was significantly higher in patie

57 ous coronary intervention for stable angina (CTO-PCI) is a rare but serious event.

58 Angiographic CTO frequently corresponds to less than complete occlusi

59 Ninety-six angiographic CTOs from autopsy studies in 61 patients who had undergo

60 Operators with annual CTO PCI volumes of at least 48 per year (the top volume

61 Carotid artery CTO was created by balloon injury in 19 lipid-overfed sw

62 otal occlusion of the right coronary artery (CTO-RCA) in patients undergoing percutaneous interventio

63 interventions and with or without associated CTO-RCA.

64 Among 4250 patients undergoing attempted CTO PCI, 40% received >=2 antianginal medications and 24

65 Post-CABG CTO PCI is associated with similar high success and low

66 hough sometimes necessary to cross a complex CTO lesion, subintimal knuckle wiring and subintimal tra

67 Procedural factors indicative of complex CTO intervention strongly related to an increased risk o

68 neous coronary intervention of a concomitant CTO.

69 d whether patients with STEMI and concurrent CTO in a non-infarct-related artery benefit from additio

70 In patients with STEMI and concurrent CTO, we did not find an overall benefit for CTO PCI in t

71 who underwent primary PCI and had concurrent CTO in 14 centers in Europe and Canada.

72 One hundred consecutive CTOs successfully treated with drug-eluting stents under

73 etrograde PCI revascularization for coronary CTOs.

74 cisions regarding patients who have coronary CTOs identified during coronary angiography.

75 e randomly assigned to early PCI of the CTO (CTO PCI), and 154 patients were assigned to conservative

76 Real-time MRI intervention used custom CTO catheters and guidewires that incorporated MRI recei

77 ntly between the two groups (median 183 days CTO group vs 8 days Section 17 group, p<0.001) the numbe

78 are required to more definitively determine CTO revascularization guidelines.

79 myocardial blood flow (MBF) after different CTO percutaneous coronary intervention techniques.

80 Appropriate use criteria ratings downgrade CTO percutaneous coronary intervention revascularization

81 dence, predictors, and outcomes of CP during CTO-PCI were defined.

82 The finding that early CTO PCI in the left anterior descending coronary artery

83 uccessful CTO treatment compared with failed CTO treatment (73.5% vs. 65.1%, p = 0.001).

84 The Florence CTO PCI registry started in 2003 and included consecutiv

85 was less common than continuation following CTO PCI, with little variation across sites.

86 n registry adopting the hybrid algorithm for CTO percutaneous coronary intervention (Registry of Cros

87 CTO, we did not find an overall benefit for CTO PCI in terms of LVEF or LVEDV.

88 Percutaneous coronary intervention for CTO remains a challenge with a high incidence of procedu

89 The success rate for CTO is low compared with the rate for other lesions.

90 Procedural success rates for CTO have not improved over time in the stent era, highli

91 its improvement among patients selected for CTO PCI.

92 agnosis of psychosis and deemed suitable for CTOs by their clinicians.

93 fTRA CTO percutaneous coronary intervention is a valid altern

94 histology, 3 underwent primary x-ray-guided CTO recanalization attempts, and the remaining 14 underw

95 pothesized that real-time MRI (rtMRI)-guided CTO recanalization can be accomplished in an animal mode

96 The rtMRI-guided CTO recanalization was successful in 11 of 14 swine and

97 atory and calibration capacity for guidewire CTO crossing within 30 minutes but it does not for final

98 Operator and hospital CTO-PCI experiences were directly related to procedural

99 2015, consecutive patients undergoing hybrid CTO-PCI were prospectively enrolled in 17 centers.

100 the outcomes of RA versus femoral access in CTO percutaneous coronary intervention.

101 vascularization on quality of life, risks in CTO revascularization, and the importance of complete re

102 n this study, supporting its expanded use in CTO interventions.

103 compared with femoral access, RA is used in CTO percutaneous coronary intervention of less complex l

104 In CTOs >1 year old, the adventitia and IP NC numbers were

105 In CTOs < 1 year old, the adventitia was associated with a

106 Angina was assessed 6 months after the index CTO PCI attempt using the Seattle Angina Questionnaire A

107 cclusion percutaneous coronary intervention (CTO PCI) techniques have led to increased procedural suc

108 J-CTO score was strongly associated with final success and

109 R: 2.43; 95% CI: 1.22 to 4.83; p = 0.011), J-CTO (Multicenter CTO Registry in Japan) score >/=3 (HR:

110 , difficult (J-CTO=2), and very difficult (J-CTO>/=3).

111 CTO=0), intermediate (J-CTO=1), difficult (J-CTO=2), and very difficult (J-CTO>/=3).

112 fty-seven lesions were classified as easy (J-CTO=0), intermediate (J-CTO=1), difficult (J-CTO=2), and

113 ost-CABG patients (175 cases) had a higher J-CTO score (2.5 versus 2.1; P=0.002).

114 lassified as easy (J-CTO=0), intermediate (J-CTO=1), difficult (J-CTO=2), and very difficult (J-CTO>/

115 The mean J-CTO (2.9+/-1.2 versus 2.2+/-1.3; P<0.001) and PROGRESS-C

116 The mean J-CTO score was 2.18+/-1.26, and successful guidewire cros

117 ance of the Japan-chronic total occlusion (J-CTO) score in predicting success and efficiency of CTO p

118 verall mean Japan-Chronic Total Occlusion (J-CTO) score was 1.43+/-1.16, with no differences between

119 minutes for every 1-point increase of the J-CTO score (regression coefficient 22.33, 95% confidence

120 The J-CTO score demonstrated good discrimination (c statistic,

121 We investigated the performance of the J-CTO score for predicting procedure complexity and succes

122 The J-CTO score has been proposed to stratify case complexity

123 The J-CTO score helps to predict complexity of CTO recanalizat

124 The impact of the J-CTO score on technical success and procedure time was ev

125 In this independent cohort, the J-CTO score showed good discriminatory and calibration cap

126 The J-CTO score was applied for each patient, and discriminati

127 The J-CTO score was associated with a 2-fold increase in the o

128 l success rate was not associated with the J-CTO score.

129 O lesions attempted using RA had lower Japan-CTO score (2.3+/-1.2 versus 2.5+/-1.3; P<0.001).

130 The average Japanese CTO score was 2.0 +/- 1.0, and was higher in the failure

131 The average Japanese CTO score was 2.1+/-1.2 in fTRA and 2.3+/-1.1 in TFA (P=

132 rable for fTRA and TFA in different Japanese CTO score subgroups after multivariable analysis and aft

133 Recanalization of long CTO is entirely feasible with the use of rtMRI guidance.

134 1.22 to 4.83; p = 0.011), J-CTO (Multicenter CTO Registry in Japan) score >/=3 (HR: 2.08; 95% CI: 1.3

135 In a large multicenter CTO percutaneous coronary interventions registry, prior

136 We delineated a cohort of new CTO operators performing <10 CTO PCI cases per given yea

137 Among a large number of new CTO PCI operators in the United States, there exists an

138 rvative treatment without PCI of the CTO (no CTO PCI).

139 O PCI arm versus 212.8 +/- 60.3 ml in the no-CTO PCI arm (p = 0.70).

140 compared with patients randomized to the no-CTO PCI strategy (47.2 +/- 12.3% vs. 40.4 +/- 11.9%; p =

141 The 10-year survival rates for matched non-CTO and the CTO cohorts were similar.

142 ng propensity scoring methods, a matched non-CTO cohort of 2,007 patients was identified and compared

143 ry artery occlusion (CTO) with a matched non-CTO cohort to determine whether successful PCI of a CTO

144 evascularization, and after treatment of non-CTO lesions at the time of the index procedure.

145 The CTO versus non-CTO 10-year survival was the same (71.2% vs. 71.4%, p =

146 tervention revascularization relative to non-CTOs and to surgical revascularization.

147 III or IV angina caused by nonrecanalizable CTOs, the performance of PTMR does not result in a great

148 f a chronic total coronary artery occlusion (CTO) with a matched non-CTO cohort to determine whether

149 oncomitant chronic total coronary occlusion (CTO) and a large collateral contribution might alter the

150 sease have chronic total coronary occlusion (CTO), which is associated with long-term mortality in pa

151 with single-vessel chronic total occlusion (CTO) and no prior myocardial infarction (MI).

152 f peripheral artery chronic total occlusion (CTO) can be challenging.

153 re after successful chronic total occlusion (CTO) drug-eluting stent-supported percutaneous coronary

154 concurrent coronary chronic total occlusion (CTO) in a non-infarct-related artery is present and is a

155 essel remote from a chronic total occlusion (CTO) is common and presents a management dilemma.

156 Chronic total occlusion (CTO) is common, being reported in 18% to 30% of patients

157 e improvement after chronic total occlusion (CTO) percutaneous coronary intervention (PCI) among pati

158 ybrid algorithm for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) was develo

159 ns (AAMs) following chronic total occlusion (CTO) percutaneous coronary intervention (PCI).

160 ssing techniques in chronic total occlusion (CTO) percutaneous coronary intervention have been develo

161 ncreasingly used in chronic total occlusion (CTO) percutaneous coronary intervention with encouraging

162 radial approach for chronic total occlusion (CTO) percutaneous coronary intervention.

163 Chronic total occlusion (CTO) recanalization is a complex and technically challen

164 tervention (PCI) of chronic total occlusion (CTO).

165 evascularization of chronic total occlusion (CTO).

166 Chronic total coronary occlusions (CTO) are found frequently in coronary artery disease; ho

167 rvention (PCI) for chronic total occlusions (CTO) has been identified as a beneficial treatment, but

168 rvention (PCI) for chronic total occlusions (CTO) over the last 25 years from a single PCI registry a

169 edural outcomes of chronic total occlusions (CTO) percutaneous coronary interventions in patients wit

170 rvention (PCI) for chronic total occlusions (CTO).

171 ic chronic total coronary artery occlusions (CTOs) were studied to define histologic correlates of ag

172 of native coronary chronic total occlusions (CTOs) after coronary artery bypass grafts (CABGs) is hig

173 e in patients with chronic total occlusions (CTOs) and predictors of its improvement after CTO percut

174 gement of coronary chronic total occlusions (CTOs) in current practice.

175 sed by one or more chronic total occlusions (CTOs) of a native coronary artery.

176 entions (PCIs) for chronic total occlusions (CTOs).

177 ms reveal coronary chronic total occlusions (CTOs).

178 and could partly account for the absence of CTO effect.

179 Specific aspects of CTO revascularization include ischemic burden, impact of

180 th hard clinical outcomes on the benefits of CTO revascularization has hampered attempts to develop r

181 e J-CTO score helps to predict complexity of CTO recanalization, and the simplicity of the score supp

182 st studies have used variable definitions of CTO, and there are limited data available from contempor

183 We also tested whether duration of CTO affected readmission outcomes in patients with CTO e

184 between readmission outcomes and duration of CTO.

185 core in predicting success and efficiency of CTO percutaneous coronary intervention has received limi

186 mong other characteristics, the existence of CTO was assessed.

187 However, the impact of CTO on the occurrence of ventricular arrhythmias and lon

188 s much higher than expected, irrespective of CTO status, and could partly account for the absence of

189 We examined outcomes of CTO percutaneous coronary intervention (PCI) post-CABG v

190 percutaneous coronary intervention (PCI) of CTO shortly after primary PCI.

191 The presence of CTO was associated with higher ventricular arrhythmia an

192 who underwent unsuccessful PCI procedures of CTO (more than three months' duration) had a repeat atte

193 Recanalization of CTO is followed by a hibernation of vascular wall at dis

194 hese findings suggest that recanalization of CTO-RCA has significant impact on the long-term cardiac-

195 Successful revascularization of CTO is associated with improved survival compared with p

196 cilitating percutaneous revascularization of CTO.

197 , we looked at the feasibility and safety of CTO PCI via saphenous vein grafts (19% of post-CABG case

198 The percutaneous treatment of CTO remains a major challenge.

199 mine the utilization and variation in use of CTO PCI, the success rates across providers, the multiva

200 While utilization of CTO PCI has disseminated widely, the learning curve for

201 We previously investigated the effect of CTOs on readmission rates over 12 months in a randomised

202 nal trial to examine the long-term effect of CTOs on readmissions and the risk of patients disengagin

203 ndations regarding the optimal management of CTOs.

204 Revascularization of CTOs is frequently characterized by inability to cross o

205 e adverse revascularization profile of older CTOs.

206 ned to be discharged from hospital either on CTO (167 patients) or Section 17 leave (169 patients).

207 io) to be discharged from hospital either on CTO or Section 17 leave.

208 sis of psychosis discharged from hospital on CTOs would have a lower rate of readmission over 12 mont

209 Methods and Results Using the 12-center OPEN CTO registry (Outcomes, Patient Health Status, and Effic

210 METHODS AND In the OPEN CTO registry (Outcomes, Patient health status, and Effic

211 a was present in 1 of 7 patients in the OPEN-CTO (Outcomes, Patient Health Status, and Efficiency in

212 Community treatment orders (CTOs) for psychiatric patients became available in Engla

213 Community treatment orders (CTOs) have not been shown in randomised trials to reduce

214 -1.2 versus 2.2+/-1.3; P<0.001) and PROGRESS-CTO (Prospective Global Registry for the Study of Chroni

215 y observed in patients with ULM and residual CTO-RCA as compared with those without residual CTO-RCA

216 eated CTO-RCA), and 46 patients had residual CTO-RCA.

217 ed less frequently in patients with residual CTO-RCA (adjusted hazard ratios, 0.321 [95% confidence i

218 ed more frequently in patients with residual CTO-RCA as compared with those without residual CTO-RCA.

219 these, 522 had ULM lesions without residual CTO-RCA (493 ULM without CTO-RCA+29 ULM with treated CTO

220 -RCA as compared with those without residual CTO-RCA (adjusted hazard ratios, 2.163 [95% confidence i

221 -RCA as compared with those without residual CTO-RCA.

222 X-ray angiography resolves CTO poorly.

223 anuary 2008 and December 2012 for retrograde CTO PCI at 44 European centers.

224 ed at feasibility and outcomes of retrograde CTO PCI via patent or occluded saphenous vein graft.

225 A successfully revascularized CTO confers a significant 10-year survival advantage com

226 eceiving ICDs for primary prevention of SCD, CTO is an independent predictor for the occurrence of ve

227 In-hospital outcomes for subsequent CTO PCIs were stratified by the number of prior cases ac

228 Successful CTO PCI was associated with improved long-term survival.

229 Successful CTO PCI was associated with more frequent dyspnea improv

230 Successful CTO-PCI supported by everolimus-eluting stents is associ

231 tion, or reocclusion 1 year after successful CTO PCI in patients treated before February 2015.

232 ut the angiographic outcome after successful CTO PCI.

233 imaging before and 3 months after successful CTO percutaneous coronary intervention between 2013 and

234 ct 10-year survival advantage for successful CTO treatment compared with failed CTO treatment (73.5%

235 of success, and the mortality of successful CTO PCI.

236 ough 12 months, and patients with successful CTO PCI had larger health status improvement than those

237 h 1-year follow-up, patients with successful CTO PCI had significantly larger degree of improvement o

238 survival benefit in patients with successful CTO PCI.

239 Patients with successful CTO PCIs were younger; had higher ejection fractions; we

240 Contemporary data suggest CTO revascularization may have substantial impact on pat

241 erwent coronary artery bypass graft surgery (CTO bypassed in 88%).

242 This review presents issues surrounding CTO revascularization within the framework of the approp

243 Multivariable analysis revealed that CTO was independently associated with appropriate ICD in

244 These data suggested that CTO-PCI safety and success could potentially be improved

245 follow-up support our original findings that CTOs do not provide patient benefits, and the continued

246 The CTO experience group had significantly more readmissions

247 The CTO target vessel in prior CABG patients was the right c

248 The CTO versus non-CTO 10-year survival was the same (71.2%

249 r survival rates for matched non-CTO and the CTO cohorts were similar.

250 rom donor and recipient vessel to assess the CTO.

251 noted no significant difference between the CTO and control groups for time to disengagement or numb

252 ar disease; and were more likely to have the CTO in the left anterior descending artery.

253 Diabetics in the CTO cohort had a lower 10-year survival compared with no

254 se cardiac event (MACE) rate was 3.8% in the CTO cohort.

255 g a total sample of 333 patients (166 in the CTO group and 167 in the Section 17 group).

256 ween groups (59 [36%] of 166 patients in the CTO group vs 60 [36%] of 167 patients in the Section 17

257 ator-reported procedural success rate in the CTO PCI arm of the trial was 77%, and the adjudicated su

258 EDV at 4 months was 215.6 +/- 62.5 ml in the CTO PCI arm versus 212.8 +/- 60.3 ml in the no-CTO PCI a

259 ersus 16.6%) were significantly lower in the CTO revasc group.

260 s were randomly assigned to early PCI of the CTO (CTO PCI), and 154 patients were assigned to conserv

261 to conservative treatment without PCI of the CTO (no CTO PCI).

262 Therefore, imaging of the CTO by computed tomographic angiography can provide addi

263 unreliable at predicting ischemia should the CTO vessel be revascularized and potentially affecting t

264 hic evidence of Q waves corresponding to the CTO artery territory in only 26% of cases.

265 patients was identified and compared to the CTO group.

266 g coronary artery who were randomized to the CTO PCI strategy had significantly higher LVEF compared

267 supplying the majority of collaterals to the CTO).

268 Technical failure to treat the CTO was not an independent predictor of long-term mortal

269 information on the vessel course within the CTO segment, specifically the degree and extent of calci

270 Half the CTOs were located in the right coronary artery.

271 ation of readmission in patients assigned to CTO versus those assigned to control, and in all patient

272 with an increased risk of CP were related to CTO complexity.

273 r a broad community of appropriately trained CTO operators.

274 ients with residual as compared with treated CTO-RCA (log-rank P=0.01) despite no difference in basel

275 (493 ULM without CTO-RCA+29 ULM with treated CTO-RCA), and 46 patients had residual CTO-RCA.

276 experienced centers, 987 patients undergoing CTO PCI (procedure success 82%) were assessed for dyspne

277 s a common symptom among patients undergoing CTO PCI and improves significantly with successful PCI.

278 success and outcomes of patients undergoing CTO-PCI.

279 erse cardiac event among patients undergoing CTO-PCIs.

280 030 (3.1%) patients undergoing PCI underwent CTO PCI with a success rate of 61.3%.

281 mong 1000 consecutive patients who underwent CTO PCI in a 12-center registry, refractory angina was d

282 ds of 650 consecutive patients who underwent CTO percutaneous coronary intervention between 2011 and

283 Approximately 0.4% of patients who underwent CTO percutaneous coronary intervention died during the i

284 al of 209 consecutive patients who underwent CTO recanalization by a high-volume operator were includ

285 5+/-20.8, P<0.01) compared with unsuccessful CTO PCI.

286 Patients with unsuccessful CTO PCIs had significantly higher 2.5-year mortality (ad

287 l compared with procedures with unsuccessful CTO, and higher-volume CTO operators are more successful

288 tudy included 56 patients with single-vessel CTO and no prior MI who underwent rest-stress myocardial

289 In the setting of single-vessel CTO and no prior MI, coronary collaterals appear to prot

290 res with unsuccessful CTO, and higher-volume CTO operators are more successful.

291 We tested whether CTOs reduce admissions compared with use of Section 17 l

292 dergoing nonurgent coronary angiography with CTO were prospectively identified at 3 Canadian sites fr

293 success and low complications compared with CTO PCI in patients who never had CABG.

294 07), whereas fibrocalcific IP increased with CTO age (p = 0.008).

295 ssigned to control, and in all patients with CTO experience at any time in the 36 months versus those

296 fected readmission outcomes in patients with CTO experience.

297 ubgroup analysis revealed that patients with CTO located in the left anterior descending coronary art

298 Almost half the patients with CTO were treated medically, and 25% underwent coronary a

299 function was normal in >50% of patients with CTO.

300 ns without residual CTO-RCA (493 ULM without CTO-RCA+29 ULM with treated CTO-RCA), and 46 patients ha