The Impact of Calcium on Chronic Total Occlusion Management
Coronary artery calcification is prevalent in chronic total occlusions (CTO), particularly in those of longer duration and post-coronary artery bypass. The presence of calcium predicts lower procedural success rates and a higher risk of complications of CTO percutaneous coronary intervention. Adjunc...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Radcliffe Medical Media
2021-10-01
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| Series: | Interventional Cardiology: Reviews, Research, Resources |
| Online Access: | https://www.icrjournal.com/articleindex/icr.2021.01 |
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| Summary: | Coronary artery calcification is prevalent in chronic total occlusions (CTO), particularly in those of longer duration and post-coronary artery bypass. The presence of calcium predicts lower procedural success rates and a higher risk of complications of CTO percutaneous coronary intervention. Adjunctive imaging, including pre-procedural computed tomography and intracoronary imaging, are useful to understand the distribution and morphology of the calcium. Specialised guidewires and microcatheters, as well as penetration, subintimal entry and luminal re-entry techniques, are required to cross calcific CTOs. The use of both atherectomy devices and balloon-based calcium modification tools has been reported during CTO percutaneous coronary intervention, although they are limited by concerns regarding safety and efficacy in the subintimal space. |
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| ISSN: | 1756-1477 1756-1485 |