Chronic total occlusions (CTO) are common, and found in approximately one third of patients with significant coronary artery disease who undergo angiography. Over the past 20 years, CTO lesions have represented the most difficult anatomy for treatment - with lower success rates and higher complication rates. Chronic Total Occlusions provides interventionalists insight into the world of CTOs with introductory chapters that describe the pathology and indications of CTOs along with a review of clinical trials. Imaging modalities including CT angiography, magnetic navigation wire, and IVUS guided recanalization of CTO are also introduced, together with information on new wires technology and devices for CTOs. With numerous illustrations of these devices, technologies, and strategies to improve the CTO success rate, this clinical guide, headed up by Ron Waksman, will prove to be the ideal companion for interventional cardiologists and cardiac surgeons who are required to perform angioplasty and coronary stenting.
Contributors. Preface. Foreword. Part I Pathology and Indications: Clinical Trials The Pathobiology of CTO1 ( Ronen Jaffe, MD, Brian Courtney, MD, & Bradley H. Strauss, MD, PhD ). 2 Indication and Outcome of PCI for CTO ( Ron Waksman, MD, FACC ). 3 CTO - Review of Trials ( Tina L. Pinto Slottow, MD & Ron Waksman, MD, FACC ). Part II Imaging. 4 CT Angiography: Application in Chronic Total Occlusions ( Hidehiko Hara, MD, John R. Lesser, MD, Nicholas Burke, MD, & Robert S. Schwartz, MD ). 5 Magnetic Navigation Wire ( Steve Ramcharitar, BMBCh, DPhil & Patrick Serruys, MD, PhD ). 6 IVUS-Guided Recanalization of CTO ( Etsuo Tsuchikane, MD, PhD ). Part III Wires Technology. 7 Defl ecting Tip Wires ( Mirko Schiemann, MD ). 8 ASAHI Wires ( Shigeru Saito, MD, FACC, FSCAI, FJCC ). 9 Tornus Catheter ( Hideaki Kaneda, MD, PhD ). 10 Introduction of a New 0.014-inch CiTop Guidewire for CTO: Preclinical Safety and Feasibility Studies ( Mickey Scheinowitz, PhD ). 11 Frontrunner CTO Technology ( Chad Kliger, MD, Steven P. Sedlis, MD, FACC, FSCAI, & Jeffrey D. Lorin, MD, FACC ). Part IV Wires Technique. 12 Use of Two Wires in the Treatment of CTO ( Thierry Lef evre, MD, FESC, FSCAI, Yves Louvard, MD, FSCAI, & Marie-Claude Morice, MD, FACC, FESC ). 13 Parallel-Wire Techniques ( Jean-Francois Surmely, MD & Takahiko Suzuki, MD ). 14 Wire Control Handling Technique ( Shigeru Saito, MD, FACC, FSCAI, FJCC ). 15 Subintimal Angioplasty ( Masashi Kimura, MD, PhD, Antonio Colombo, MD, Eugenia Nikolsky, MD, PhD, Etsuo Tsuchikane, MD, PhD, & George Dangas, MD, PhD ). 16 Re-entry Technique - Pioneer Catheter ( Nicolaus Reifart, MD, PhD, FESC, FACC, RANS ). 17 Bilateral Approach ( Jean-Francois Surmely, MD & Osamu Katoh, MD ). 18 Tips and Tricks of the CART Technique ( Osamu Katoh, MD ). Part V Devices Technology. Radio Frequency ( Richard Heuser, MD, FACC, FACP, FESC ). 20 High-Frequency Mechanical Revascularization ( Eberhard Grube, MD & Lutz Buellesfeld, MD ). 21 Debulking of CTO ( Etsuo Tsuchikane, MD, PhD ). 22 Vibrational Angioplasty ( Lampros K. Michalis, MD, MRCP, FESC ). 23 Drug-Eluting Stents ( David E. Kandzari, MD ). 24 Laser for CTO Recanalization ( On Topaz, MD ). Part VI Complications. 25 How to Handle Complications ( Axel de Labriolle, MD & Ron Waksman, MD ). 26 How to Minimize Contrast Nephropathy ( Robin Mathews, MD & Luis Gruberg, MD, FACC ). Part VII Interesting Cases. 27 Interesting Cases I, II ( Takafumi Tsuji, MD & Hideo Tamai, MD ). Index. Colour plates.