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Chronic Total Occlusions: A Guide to Recanalization, 2nd Edition

ISBN: 978-0-470-65854-3
320 pages
May 2013, Wiley-Blackwell
Chronic Total Occlusions: A Guide to Recanalization, 2nd Edition (0470658541) cover image


"Chronic total occlusions continue to represent one of the greatest challenges to interventional cardiologists." - Cardiovascular Research Foundation -

Chronic Total Occlusions or CTOs can be found in 30% of patients with coronary artery disease.
Despite advances, CTOs remain one of the most frequently identified lesions in interventional cardiology yet least likely to be successfully treated.

The prevalence of the disorder is vexing. The threat to your patients is significant. The condition is complex. And, treatment remains a challenge.

Learn how to approach CTOs from internationally-recognized physician-educators
Turn to Chronic Total Occlusions: A Guide to Recanalization, 2e for expert insight into the world of CTOs and clear, practical guidance you can apply directly and immediately in your cath lab.

Offering the most comprehensive information available, this completely updated second edition provides you wih:

  • Full-color images from the diagnostic modalities that are essential in identifying CTOs
  • Data on indications and efficacy from the most recent clinical trials
  • Practical guidance on the selection and use of the latest wires and devices
  • Even more tips and tricks from leading operators from the world’s busiest centers
  • Clinical cases to illustrate some of the more complex scenarios and common complications
  • And more!

Chronic Total Occlusions: A Guide to Recanalization, 2e is the guide you can count on to improve the CTO success rate at your facility. Order your copy today!

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Table of Contents

List of Contributors vii

Foreword xi

Preface xii

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

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Author Information

Edited by
Ron Waksman, MD, FACC
Division of Cardiology, MedStar Washington Hospital Center, Washington, DC, USA

Shigeru Saito, MD, FACC, FSCAI, FJCC
Cardiology & Catheterization Laboratories, Shonan Kamakura General Hospital, Kamakura, Japan

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“This is a very helpful book for those interested in invasive treatment of CTOs.  The authors provide practical explanations, supplemented by detailed imaging and pragmatic discussions of the latest advances in their treatment.”  (Doody’s, 4 October 2013)

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