Chronic Total Occlusions. A Guide to Recanalization

List of Contributors 

Foreword 

Preface 

Part I Pathology, Indications, and Review of Clinical Trials

1 The pathobiology of CTO 3
Sergey Yalonetsky, Azriel B. Osherov & Bradley H. Strauss

2 Collateral circulation in CTO 9
Alfredo R. Galassi, S.D. Tomasello & Hazem Khamis

3 CTO: review of trials 18
Tina L. Pinto Slottow & Ron Waksman

4 CTO-percutaneous coronary intervention: what is the evidence? 26
Gabriel Maluenda, Tina L. Pinto Slottow & Ron Waksman

5 Case selection and long-term benefits 33
Imran N. Ahmad, Kamran I. Muhammad & Patrick L. Whitlow

Part II Imaging

6 CT angiography: application in chronic total occlusions 45
Hidehiko Hara, John R. Lesser, Nicholas Burke & Robert S. Schwartz

7 Co-registration CTO and CT angiography 51
Gary M. Idelchik & Ariel Roguin

8 Optical coherence tomography to guide the treatment of chronic total occlusions 60
Nicola Viceconte, Rodrigo Teijeiro-Mestre, Nicolas Foin, Alistair C. Lindsay and Carlo Di Mario.

9 IVUS-guided CTO-PCI 67
Masashi Kimura & Yasushi Asakura

10 IVUS evaluation of CTO 78
Akiko Maehara, Masahiko Ochiai & Gary S. Mintz

11 Magnetic navigation wire 85
Steve Ramcharitar & Patrick Serruys

Part III Wires Technology

12 Deflecting wire systems 93
Mirko Schiemann

13 Asahi wires 97
Shigeru Saito

14 IVUS-guided recanalization of CTO 105
Etsuo Tsuchikane

15 Frontrunner CTO technology 109
Chad Kliger, Steven P. Sedlis & Jeffrey D. Lorin

16 Channel dilator: Corsair 113
Masashi Kimura

Part IV Wires Technique

17 Tornus catheter 121
Hideaki Kaneda

18 Antegrade approach: step by step 126
Nicolaus Reifart

19 Use of two wires in the treatment of CTO 134
Yves Louvard, Thierry Lefèvre & Marie-Claude Morice

20 Parallel-wire techniques 143
Sudhir Rathore & Takahiko Suzuki

21 Guidewire handling techniques for CTO lesions 147
Shigeru Saito

22 Subintimal angioplasty in coronary CTO 155
Philippe Généreux & George D. Dangas

23 Antegrade device assisted re-entry techniques 162
Nicolaus Reifart

24 The microchannel technique 166
Mauro Carlino, Gill L. Buchanan & Cosmo Godino

25 The STAR technique 172
Cosmo Godino, Mauro Carlino & Antonio Colombo

26 Attempting CTO after first failed attempt 178
Sudhir Rathore & Takahiko Suzuki

27 Transradial approach for CTO lesions and tapered-tip guidewires 184
Shigeru Saito

28 Bilateral approach 191
Osamu Katoh

29 Tips and tricks of the CART technique 198
Osamu Katoh

Part V Devices Technology

30 Recanalizing total occlusion in the periphery: utilization of radio frequency and other technology 209
Shishir Murarka & Richard Heuser

31 High-frequency mechanical revascularization 226
Eberhard Grube & Lutz Buellesfeld

32 Debulking of CTO 230
Etsuo Tsuchikane

33 Vibrational angioplasty 235
Lampros K. Michalis

34 Treatment of chronic total coronary occlusions with drug-eluting stents: overview of angiographic and clinical outcomes 240
David E. Kandzari

35 Laser for CTO recanalization 251
On Topaz

36 The ENABLER-P: a novel CTO crossing cystem 257
Maurice Buchbinder

37 Collagenase plaque digestion for facilitating guidewire crossing 262
Azriel B. Osherov & Bradley H. Strauss

38 The BridgePoint re-entry system 268
Imran N. Ahmad, Kamran I. Muhammad & Patrick L. Whitlow

Part VI Complications

39 Complications during the retrograde approach for CTO 275
Shigeru Saito

40 CTO: how to minimize contrast nephropathy 279
Travis J. Bench & Luis Gruberg

Part VII Interesting Cases

41 Interesting cases I–VI 291
Shigeru Saito

Index 301

Understand and remedy chronic total occlusions with the third edition of this comprehensive guide

Chronic Total Occlusions offers the most comprehensive overview of chronic total occlusions(CTO) on the market, authored by two internationally recognized physician educators. It covers both the diagnostic modalities and treatment methods required to tailor a treatment program to individual cardiological patients with the greatest possible chance of success. Thorough and informed by the latest research and field data, the third edition of this guide is an indispensable resource for interventional cardiologists.

In Chronic Total Occlusions: A Guide to Recanalization, Third Edition, readers will also find:

• Full-color images to guide diagnosis of CTOs
• Expert tips and tricks for key procedures involved in treating challenging cases
• Clinical case studies illustrating specific scenarios and frequently encountered complications

Chronic Total Occlusions: A Guide to Recanalization, Third Edition is a must-have for interventional cardiologists who want to maximize their patient outcomes.

Ron Waksman, MD, is Director of Clinical Research and Advanced Education and Associate Director of the Cardiology Division at MedStar Heart Institute, as well as Clinical Professor of Medicine (Cardiology) at Georgetown University, Washington, DC., USA. He is editor-in-chief of the journal Cardiovascular Revascularization Medicine and has published hundreds of articles on interventional cardiology.

Shigeru Saito, MD, is Director of the Cardiology and Catheterization Laboratories and Vice Director at Shonan Kamakura General Hospital, Kamakura, Japan. He sits on the editoral boards of numerous journals and has published extensively on interventional cardiology.