Modified contrast microinjection technique to facilitate chronic total occlusion recanalization.

Autor: Carlino M; San Raffaele Scientific Institute, Milan, Italy., Ruparelia N; San Raffaele Scientific Institute, Milan, Italy.; Imperial College, London, United Kingdom., Thomas G; Belfast Healthcare Trust, Belfast, Northern Ireland, United Kingdom., Brooks M; Edinburgh Royal Infirmary, Edinburgh, United Kingdom., Uretsky BF; Central Arkansas Veterans Health System, Little Rock, Arkansas., Brilakis ES; University of Texas Southwestern Medical Center, Texas., Karmpaliotis D; Presbyterian Hospital/Columbia University Medical Center, New York., Hanratty C; Belfast Healthcare Trust, Belfast, Northern Ireland, United Kingdom., Walsh S; Belfast Healthcare Trust, Belfast, Northern Ireland, United Kingdom., Spratt J; Edinburgh Royal Infirmary, Edinburgh, United Kingdom., Colombo A; San Raffaele Scientific Institute, Milan, Italy.
Jazyk: angličtina
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2016 May; Vol. 87 (6), pp. 1036-41. Date of Electronic Publication: 2015 Sep 10.
DOI: 10.1002/ccd.26242
Abstrakt: Objectives: To assess the efficacy and safety of the modified contrast microinjection technique to facilitate chronic total occlusion recanalization.
Background: The success rate of chronic total occlusion percutaneous coronary intervention (CTO-PCI) does not exceed 90% even in the most experienced centres. We have previously demonstrated that a large volume of contrast injected into the subintimal space can facilitate recanalization but is limited by a risk of serious complication. The aim of this study was to assess the application, efficacy and safety of a modified contrast microinjection technique that utilizes the injection of a much smaller volume of contrast in CTO-PCI.
Methods: A retrospective analysis of patients in whom the modified microinjection technique was utilised in patients undergoing CTO-PCI at five tertiary centres was conducted.
Results: Of 1,192 patients who underwent CTO-PCI, the microinjection technique was used in 59 patients (4.7%). The majority of CTOs treated were in the right coronary artery (79.7%), were of high complexity and 35.6% of lesions had a least one previously failed PCI attempt. The modified microinjection technique was used for more than one indication in 7 (11.9%) of patients. The success rate was 81.4%. There were no procedural complications related to the use of the reported modified microinjection.
Conclusion: Initial experience with the modified microinjection demonstrates that it can be performed safely, is reproducible, and is broadly applicable. Whilst not required for all CTO procedures it can be a helpful adjunctive tool to increase the likelihood of success especially in complex, or refractory cases, without compromising the safety of the procedure. © 2015 Wiley Periodicals, Inc.
(© 2015 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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