RETROGRADE RECANALISATION OF CORONARY CHRONIC TOTAL OCCLUSIONS
https://doi.org/10.24060/2076-3093-2017-7-1-10-15
Abstract
Chronic total occlusion of coronary arteries is a condition that is technically difficult to solve by the x-ray surgical methods of treatment, and that is one of the decisive factors in favor of coronary artery bypass grafting. The article presents the results about 27 retrograde recanalization of chronic coronary occlusions and the analysis of reasons of unsuccessful attempts, the frequency and severity of re-operative complications. Retrograde recanalization of chronic total coronary occlusions turned out to be effective in the condition of minimally invasive tactics of myocardial revascularization in single long occlusion. Good distal direction and class CC1 and CC2 collarile appeared to be the main criteria of successful retrograde recanalization. Retrograde recanalization complications are typical for x-ray surgical methods of diagnostics and treatment, they are easily predicted, and the prevention methods are well known and effective. Thus, retrograde recanalization of chronic total coronary occlusions is an efficient way of treatment in case of careful patients’ selection and it should be added to frequently used antegrade recanalization method. The key factors for development and widespread implementation of this method are integration of x-ray surgical methods of diagnostics and treatment together with visualization methods and fluoroscopy with IVUS.
About the Authors
A. A. Larionov
Federal State Budgetary Institution “Federal Centre for Cardiovascular Surgery”
Russian Federation
Russian Federation
X-ray Endovascular Diagnostics and Treatment physician at the X-ray Surgical Methods of Diagnostics and Treatment Department,
Astrakhan
D. P. Gaponov
Federal State Budgetary Institution “Federal Centre for Cardiovascular Surgery”;
Federal State Budgetary Educational Institution of Higher Education “Astrakhan State Medical University”
Russian Federation
Russian Federation
X-ray Endovascular Diagnostics and Treatment Physician at the X-ray Surgical Methods of Diagnostics and Treatment Department, Astrakhan;
Assistant Professor at the Cardiovascular Surgery Department, Astrakhan
M. G. Gorbunov
Federal State Budgetary Institution “Federal Centre for Cardiovascular Surgery”
Russian Federation
Chair at the X-ray Surgical Methods of Diagnostics and Treatment Department, Astrakhan
Russian Federation
Chair at the X-ray Surgical Methods of Diagnostics and Treatment Department, Astrakhan
D. A. Korzh
Federal State Budgetary Institution “Federal Centre for Cardiovascular Surgery”
Russian Federation
Russian Federation
X-ray Endovascular Diagnostics and Treatment Physician at the X-ray Surgical Methods of Diagnostics and Treatment Department,
Astrakhan
T. N. Kudba
Federal State Budgetary Educational Institution of Higher Education “Astrakhan State Medical University”, Health Ministry of the Russian Federation
Russian Federation
Russian Federation
Surgeon, the Hospital Surgery Department Assistant Professor,
Astrakhan
S. A. Kuznetsov
Federal State Budgetary Educational Institution of Higher Education “Astrakhan State Medical University”, Health Ministry of the Russian Federation
Russian Federation
Russian Federation
Anesthesiologist,
Astrakhan
References
1. Бирюков АВ. Эндоваскулярная ретроградная реканализация хронических окклюзий коронарных артерий [диссертация канд. мед. наук]. Новосибирск; 2010.
2. Бокерия ЛА, Алекян БГ. Руководство по рентгеноэндоваскулярной хирургии сердца и сосудов. М.: НЦССХ им. А. Н. Бакулева РАМН; 2008: 527-598.
3. Бокерия ЛА, Гудкова РГ. Сердечно-сосудистая хирургия. Болезни и врожденные аномалии системы кровообращения. М.: НЦССХ им. А. Н. Бакулева РАМН; 2012: 156 с.
4. Карпов ЮА, Самко АН, Буза ВВ. Коронарная ангиопластика и стентирование. М.: Медицинское информационное агентство; 2010: 316 с.
5. Christofferson RD, Lehmann KG, Martin GV, Every N, Caldwell JH, Kapadia SR. Effect of chronic total occlusion on treatment strategy. Am J Cardiol. 2005;95:1088-1091. DOI:10.1016/j.amjcard.2004.12.065.
6. Galassi AR. Percutaneous coronary interventions for chronic total occlusions. Galassi’s tips and tricks. Alpha; 2010: 1-363.
7. Galassi AR, Tomasello SD, Reifart N, Werner GS, Sianos G, Bonnier H. et al. In-hospital outcomes of percutaneous coronary intervention in patients with chronic total occlusion: insights from the ERCTO (European Registry of Chronic Total Occlusion) registry. EuroIntervention. 2011;7(4): 472-479. DOI: 10.4244/EIJV7I4A77.
8. Melchior JP, Doriot PA, Chatelain P, Meier B, Urban P, Finci L, et al. Improvement of left ventricular contraction and relaxation synchronism after recanalization of chronic total coronary occlusion by angioplasty. J Am Coll Cardiol. 1987;9:763-768. PMID: 2951420.
9. Saito S. Different strategies of retrograde approach in coronary angioplasty for chronic total occlusion. Catheteriz Cardiovasc Interv. 2008;71(1):8-19. DOI: 10.1002/ccd.21316.
10. Surmely JF, Tsuchikane E, Katoh O, Nishida Y, Nakayama M, Nakamura S, et al. New concept for CTO recanalization using controlled antegrade and retrograde subintimal tracking: the CART technique. J Invasive Cardiol. 2006;18(7):334-338. PMID: 16816442.
11. Muramatsu T, Tsuchikane E, Oikawa Y, Otsuji S, Fujita T, Ochiai M, et al. Incidence and impact on midterm outcome of controlled subintimal tracking in patients with successful recanalisation of chronic total occlusions: J-PROCTOR registry. EuroIntervention. 2014;10:681-688. DOI: 10.4244/EIJV10I6A119.
12. Reifart N, Werner GS. Subintimal wire pathway: part of the game of crossing chronic total coronary occlusions. EuroIntervention. 2014;10(6):655-657. DOI: 10.4244/EIJV10I6A115.
13. Werner GS, Ferrari M, Heinke S, Kuethe F, Surber R, Richartz BM, et al. Angiographic assessment of collateral connections in comparison with invasively determined collateral function in chronic coronary occlusions. Circulation. 2003;107(15):1972-1977. DOI: 10.1161/01.CIR.0000061953.72662.3A
Review
For citations:
Larionov A.A., Gaponov D.P., Gorbunov M.G., Korzh D.A., Kudba T.N., Kuznetsov S.A. RETROGRADE RECANALISATION OF CORONARY CHRONIC TOTAL OCCLUSIONS. Creative surgery and oncology. 2017;7(1):10-15. (In Russ.) https://doi.org/10.24060/2076-3093-2017-7-1-10-15
Views:
2846
Email this article 