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: Claudia Cosgrove, Kalaivani Mahadevan, James C Spratt, Margaret McEntegart
Format: Article
Language:English
Published: Radcliffe Medical Media 2021-10-01
Series:Interventional Cardiology: Reviews, Research, Resources
Online Access:https://www.icrjournal.com/articleindex/icr.2021.01
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author Claudia Cosgrove
Kalaivani Mahadevan
James C Spratt
Margaret McEntegart
author_facet Claudia Cosgrove
Kalaivani Mahadevan
James C Spratt
Margaret McEntegart
author_sort Claudia Cosgrove
collection DOAJ
description 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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institution Kabale University
issn 1756-1477
1756-1485
language English
publishDate 2021-10-01
publisher Radcliffe Medical Media
record_format Article
series Interventional Cardiology: Reviews, Research, Resources
spelling doaj-art-2d26e623d6be459580a6d6c80c2a38812024-12-14T16:03:02ZengRadcliffe Medical MediaInterventional Cardiology: Reviews, Research, Resources1756-14771756-14852021-10-011610.15420/icr.2021.01The Impact of Calcium on Chronic Total Occlusion ManagementClaudia Cosgrove0Kalaivani Mahadevan1James C Spratt2Margaret McEntegart3St George’s University Hospitals NHS Foundation Trust, London, UKBristol Heart Institute, Bristol, UKSt George’s University Hospitals NHS Foundation Trust, London, UKGolden Jubilee National Hospital, Glasgow, UKCoronary 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.https://www.icrjournal.com/articleindex/icr.2021.01
spellingShingle Claudia Cosgrove
Kalaivani Mahadevan
James C Spratt
Margaret McEntegart
The Impact of Calcium on Chronic Total Occlusion Management
Interventional Cardiology: Reviews, Research, Resources
title The Impact of Calcium on Chronic Total Occlusion Management
title_full The Impact of Calcium on Chronic Total Occlusion Management
title_fullStr The Impact of Calcium on Chronic Total Occlusion Management
title_full_unstemmed The Impact of Calcium on Chronic Total Occlusion Management
title_short The Impact of Calcium on Chronic Total Occlusion Management
title_sort impact of calcium on chronic total occlusion management
url https://www.icrjournal.com/articleindex/icr.2021.01
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