Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_3764_Библиотеки_им_академика_М_И_Перельмана
.pdf
38 PART II Imaging
(d)
(f)
(a)
(b)
Figure 5.4 (a) Long RCA-CTO. (b) Parallel-wiring technique
using stiff wires could not provide successful wire crossing.
(c) An IVUS catheter was advanced through the wire in the
false channel. (d) The image clearly showed an expanded
subintimal space and a collapsed true channel. (e and f)
Then a tapered stiff wire (Confianza, Asahi Intecc, Japan)
(c)
(g)
(e)
(h)
was delivered under the IVUS guidance to penetrate the
true channel from subintimal space and this procedure
was finally successful. (g) The wire was carefully advanced
to the distal true lumen. (h) Final angiographic result after
multiple stenting.
Also an 8 Fr guiding catheter is indispensable to conduct the simultaneous wiring under IVUS guidance.
After successful wire crossing, multiple stenting is
mandatory to fully cover the enlarged subintimal
space. However, by using this technique, we can
retrieve some of unsuccessful CTOs initially performed by angiographical guidance [3, 4]. Thus, this
technique could be one of the last alternatives in the
antegrade approach when standard wiring procedures
fail in cases without a chance of retrograde approach.
A representative case is shown in Figure 5.4.
New technologies of IVUS-guided
recanalization of CTO
Recently, a low-profile IVUS catheter has been developed in Japan, which enables us to perform IVUSguided re-entry from intimal or sub-intimal space
more precisely and intentionally [5]. These new technologies warrant further evaluation to open another
door of CTO-PCI.
References
1 Stone GW, Colombo A, Teirstein PS et al. Percutaneous
recanalization of chronically occluded coronary arteries:
procedural techniques, device, and results. Cathet
Cardiovasc Interv 2005; 66: 217–236.
2 Werner GS, Diedrich J, Schlz KH et al. Vessel reconstruc-
tion in total coronary occlusions with a long subintimal
wire pathway: use of multiple stents under guidance of
intravascular ultrasound. Cathet Cardiovasc Diagn 1997;
40: 46–51.
3 Ito S, Suzuki T, Ito T et al. Novel technique using intravas-
cular ultrasound-guided guidewire cross in coronary
intervention for uncrossable chronic total occlusions. Circ
J 2004; 68: 1088–1092.
4 Matsubara T, Murata A, Kanyama H et al. IVUS-guided
wiring technique: promising approach for the chronic
total occlusion. Catheter Cardiovasc Interv 2004; 61:
381–386.
5 Suzuki S, Okamura A, Nagai H et al. Tip detection-ante-
grade dissection and reentry using intravascular ultrasound in chronic total occlusion intervention: first human
case report. Eur Heart J Case Rep 2022; 6: 1–5.
6
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
CHAPTER 6
Optical Coherence Tomography to
Guide the Treatment of Chronic
Total Occlusions
Francesca Maria Di Muro*, Giulia Nardi, Niccolò Ciardetti,
Selcuk Kucukseymen, Alessio Mattesini & Carlo Di Mario*
Structural Interventional Cardiology, Department of Clinical and Experimental Medicine,
Careggi University Hospital, Clinica Medica, Florence, Italy
* Corresponding authors
Introduction
Percutaneous coronary intervention (PCI) of chronic
total occlusions (CTO) has been rapidly evolving in
recent years [1].The main limitation approaching a
CTO by PCI remains the inability to visualize the
lesion. X ray coronary angiography is the cornerstone
imaging modality in the cardiac catheterization laboratory, but it has well-known limitations. It does not allow
the operator to determine the course of the occluded
vessel, making the progression of a stiff guidewire quite
a blind operation, especially in the absence of an angiographically visible stump. Furthermore, angiography is
unable to give a precise estimation of the lesion characteristics, from vessel remodeling to calcium burden,
and does not offer sufficient information to guide
optimal stent sizing and placement.
The development of intracoronary imaging techniques, such as intravascular ultrasound (IVUS) and
optical coherence tomography (OCT), has improved
the success rate for CTO recanalization, providing
additional information that is complementary to
angiography [2],reducing complications, contrast
medium injection, and procedural time. Intravascular
imaging thus aids in the selection of treatment strategies and guidance of percutaneous coronary intervention (PCI) [3].Optical coherence tomography
(OCT) has gained wide acceptance to select the correct
stent diameter and length, to optimize stent deployment
and identify complications. In this chapter we focus on
the specificities of OCT guidance in the treatment of
chronic total occlusions.
Principles of intra-coronary optical
coherence tomography
Optical coherence tomography (OCT) performs
high-resolution cross-sectional tomographic imaging
of the microstructure of the vessel wall [4]. OCT uses
a catheter to deliver and collect near infrared light
(e.g., 1,300 nm) to create cross-sectional and three
dimensional volumetric images of the lumen microstructures and wall by measuring the amplitude and
time delay of the backscattered light.
The shorter wavelength of the infrared light in OCT
m) compared with ultrasound in IVUS (~40 m
(1.3
at 40 MHz) confers greater axial resolution (10–20 m
versus 50–150 m) but lower penetration depth
(1–2 mm versus 5–6 mm), which limits OCT imaging,
particularly in the presence of highly attenuating structures such as red thrombus or lipid/necrotic core.
A. Ziad et al. [3] described the necessary steps for
OCT imaging acquisition as four “P”s: position, purge,
puff, and pullback. The OCT catheter is advanced on
the coronary guidewire and located distal to the target
lesion, then it is again purged, a small volume of flush is
“puffed” through the guide catheter to evaluate
clearance (if clarity is marginal, the engagement of the
Chronic Total Occlusions: A Guide to Recanalization, Third Edition. Edited by Ron Waksman and Shigeru Saito.
© 2024 John Wiley & Sons Ltd. Published 2024 by John Wiley & Sons Ltd.
39
40 PART II Imaging
Table 6.1 Advantages and disadvantages of intravascular ultrasound and optical coherence tomography for PCI guidance
and optimization.
IVUS OCT
• Extensive clinical experience (IVUS has been used clinically for
all most three decades).
• Contrast free technique. • Additional contrast.
• IVUS can guide the operator to identify the ideal entry point
to the CTO, particularly in occlusions at the bifurcation,
stumpless occlusions, and ostial occlusions.
• Crucial role in optimizing stent implantation and for the
detection of procedure-related vessel damage in both
antegrade and retrograde techniques.
• Tissue characterization is limited. • Better tissue characterization. Calcium burden
• Assessment of strut malapposition, stent expansion is limited. • Useful to detect edge dissection, tissue
• Less clinical experience but 10x higher
resolution compared with IVUS.
• Risk of damage if OCT is used to monitor the
progression of a second wire in the true
lumen with the first one (and OCT) positioned
in the subintimal space.
• Useful in PCI guidance, choosing lesion
preparation technique and stent measurements according to EEL-EEL algorithm.
estimation according to 5s algorithm.
coverage of stent struts, and malapposition.
guide catheter with regard to the target vessel is checked
and adjusted), and pullback is activated.
In severely stenotic lesions where the OCT catheter
may not cross the target lesion or the vessel clearance is
expected to be poor, predilation should be performed.
It is possible to perform cine angiography during
pullback and utilize contrast injection for angiography and OCT co-registration if available.
There are multiple intracoronary imaging OCT systems, the two most employed are the OPTISTM system
(Abbott Vascular, Santa Clara, CA, USA), which also
provides combined angiographic and the Lunawave
system (Terumo Corporation, Tokyo, Japan).
®
Image interpretation has been facilitated by the
application of Artificial Intelligence (AI). In the most
recent Ultreon OCT system (Abbott Vascular, Santa
Clara, CA, USA) a Deep Learning (DL) data-driven
AI algorithm [5] has been implemented, based on the
observation of data by training a designed model, to
make predictions in unexplored data sets. In the next
future this new technology might guarantee an
objective imaging analysis with a full quantification of
plaque composition to optimize percutaneous coronary intervention (PCI) outcomes. At present the
main advantage of AI-OCT is the automatic detection
of calcific plaques, with accurate off line analysis of
calcium distribution and thickness [6].
Use of imaging and OCT for CTO
lesion crossing
CTO recanalization with a guidewire is the most
important and difficult step in CTO intervention [7],
sometimes complicated by subintimal crossing and
the creation of a false lumen or by a complete wire
exit. Intracoronary imaging can be useful to clarify
anatomical structures that cannot be identified by
angiography alone, especially with an ambiguous
position of the proximal occlusion cap. In particular,
the use of IVUS in the recanalization of CTO enables
precise location of the guidewires within an artery (i.e.
true lumen versus subintima) [8].
It can also determine the optimal entry point and
evaluate guidewire penetration of the proximal cap of
a CTO.
Even when the guidewire enters into the subintimal
space and attempts to re-enter the true lumen under
fluoroscopic guidance are unsuccessful, IVUS may
facilitate the location of the true lumen. An IVUS catheter can be placed into the subintimal space after predilation with a balloon catheter, and then be advanced
into the subintimal tract. A second guidewire can then
be advanced alongside the IVUS catheter [9].
IVUS is also useful to guide complex retrograde
approaches that involve facing the lesion from both
directions, advancing a balloon over the antegrade wire
and inflating it within the intimal or subintimal space,
allowing the IVUS catheter to be advanced and positioned opposite to the retrograde wire. The retrograde
wire can then be manipulated from the distal vessel
position, which can be intimal or subintimal, into the
true lumen and beyond the occluded segment.
In theory an OCT catheter positioned in a sidebranch originating at the site of the occlusion is able to
identify the stump with equal or greater accuracy than
IVUS [10]. This requires the injection of crystalloids
(generally contrast) at high pressure to clear the blood
and complicates the advancement under imaging of
the second guidewire (Figure 6.1). The inconvenience
generated by the need of repeated high pressure injection becomes a real risk of damage if OCT is used to
monitor the progression of a second wire in the true
CHAPTER 6 Optical Coherence Tomography to Guide the Treatment of Chronic Total Occlusions 41
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
Figure 6.1 (a) CTO of the posterolateral branch
originating from the mid segment of the dominant LCx.
(b) Preinterventional OCT showed precisely the
localization and morphology of the CTO entry point. (c)
Venture catheter with a deflectable tip and OCT imaging
probe in the LCx. (d) There is a visible shadow from the
Venture catheter and leading guidewire for the OCT
probe. OCT confirmed good position of the guidewire
lumen with the first one (and OCT) positioned in the
subintimal space. A power injection of contrast with
the OCT catheter in the subintimal space can obviously cause progression of the dissection downstream
and should therefore be avoided.
Assessment of CTO length and
prediction of stent measurements
In CTO PCI, the potential for stent undersizing at the
index procedure is high, because of persistent vasoconstriction of the distal occluded segment, not
immediately reversible with vasodilators. On the
other hand, overaggressive post-dilatation can result
in vessel perforation in the presence of wire passage in
the subintimal space and in a vessel segment with
severe calcification and negative remodeling [11].
Lesion length, location, composition, and complexity are predictors of stent failure. Increasing CTO
length predicts escalation through the hybrid algorithm
and subsequent procedural success. In a retrospective
analysis by Tian et al., 5-year outcomes demonstrated
CTO length >15 mm to be a predictor of TLR, whereas
Ahn et al. found CTO length >30 mm was associated
with higher repeat PCI driven by TVR at 2 years
[12,13].
For this reason, an imaging guided PCI is crucial to
assess lesion morphology, to guide lesion preparation
puncturing the entry point of CTO. (e) Angiographic
result after implantation of stent into the posterolateral
branch with corresponding OCT cross-sections (I–III). OCT
cross-section images before final kissing balloon: (I) Well
apposed struts in the posterolateral branch distal to the
bifurcation. (II) Floating struts at the level of the
bifurcation. (III) Malapposed struts just proximal to the
bifurcation in the LCx.
and characterize the stent landing zones, thus allowing precise selection of balloons and stents.
OCT is able to identify a sufficiently “healthy”
vessel reference segment proximal and distal to accurately predict the stent length. By scrolling through
the OCT cross-sections at these sites, the most
“normal” segments (such as segments within 5
mm
from the lesion edges where there is minimal atherosclerotic plaque and hence greatest visibility of the
arterial media are selected as proximal and distal reference frames) [14, 15]. The length of the lesion is
then automatically calculated by the OCT software.
The modern Ultreon
to automatically define these two vessel references
1.0 Software system uses AI
™
and predict stent length.
Then, according to the most recently proposed
algorithm, an EEL-guided sizing strategy should be
preferred instead of a lumen guided strategy that leads
to the selection of a smaller stent/balloon size
increasing mismatch and post procedural complication. This strategy can be used only if greater than
180° of EEL can be visualized. EEL-based measurements should be rounded down to determine the
device size. If EEL is not visible the mean lumen diameter, recorded from the automated lumen profile feature, is utilized for device sizing rounded up to
0.25 mm above. The distal measurements determine
the stent size and post-dilation balloon size at the
42 PART II Imaging
Figure 6.2 OCT demonstrating the presence of a false
lumen during the treatment of a heavily diseased left
circumflex artery. Cypher 2.75×33 mm at 20 atm postdil
prox 3.0 26 atm and kissing LCX-OM with 3.0 and 2.0
balloon at 12 atm (a) Initial angiogram. (b) Following initial
distal end of the stent, and the proximal measurements determine the balloon size for post-dilation at
the proximal end of the stent.
Assessment of vessel wall
constituents
Even if OCT has a limited role before lesion crossing
(i.e., crossing the stump lesion), it could be best
applied following crossing and dilatation of the diseased segment. When the distal vessel is successfully
accessed and the operator is confident that an anterograde true-to-true lumen crossing was achieved, an
OCT pull-back can then be performed during high
pressure injection to accurately characterize some
important vascular parameters not identified with
angiography (and occasionally also with IVUS).
OCT offers a detailed assessment of normal and
diseased morphology feasible by understanding the
optical attenuation characteristics of vascular tissue
layers. An algorithm recently developed could be
useful in describing the most frequent pathological
treatment. (c) OCT of proximal vessel. (d) Stent interruption;
no stent struts can be seen. (e) Bifurcation LCX/OM. (f and
g) “Biluminal” segment of the vessel, the second guidewire
is clearly visible (asterisks). (h) End of the biluminal segment.
(i) Angiographic final result. (l) OCT final result.
findings in the vessel wall. It includes low-attenuating,
signal-rich lesions (fibrous plaques), high- attenuating,
signal-poor regions covered with fibrous cap (lipidrich plaques), low-attenuating, sharply delineated,
signal-poor regions (calcific plaques), and those
inside the lumen, including the low-attenuating white
thrombus and the high-attenuating red thrombus that
casts a shadow on the vessel wall.
CTOs, compared with other lesions, are characterized by greater plaque burden, longer segments
of disease, and the presence of higher amounts of
calcium. Calcification in CTOs presents additional
challenges during revascularisation of these complex coronary lesions. The presence of calcium predicts lower procedural success rates and a higher
risk of complications. Pre-procedural CTCA and
intravascular imaging are useful tools to understand the distribution, morphology, and severity of
calcium [16, 17].
In calcified lesions, IVUS is able to determine the
calcification arc but not its thickness because of reflection of ultrasound waves off calcium. In contrast,
CHAPTER 6 Optical Coherence Tomography to Guide the Treatment of Chronic Total Occlusions 43
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
OCT allows determination of both calcification arc
and thickness in most cases.
In particular, the modern Ultreon software is able
to self-detect and measure calcium angle and maximal thickness, giving an objective estimation of
calcium burden. Each OCT frame shows an orange
arc which represents calcium augmentation. It is calculated from the lumen center and is displayed only
when calcium angle is at or above 60 degrees of circumferential calcium. On the other side, calcium
thickness is indicated by a small triangle and calcium
length automatically displayed below the longitudinal
pullback.
These measurements can be entered into the
Fujino score, [18]developed from a multivariate
linear regression model to correlate calcium burden
and predict stent under expansion [19]. The parameters which correlate with poor outcomes may be easily
recalled as the “rule of 5s”: 1 point for maximum
thickness >0.5 mm, 1 point for contiguous length of
calcium >5
mm, and 2 point for maximum arc >50 %
of the circumference of the vessel (i.e., >180° of the
circumference)
Target lesions with a total score of ≥3 requires
lesion preparation with cutting or scoring balloon,
atherectomy, or intravascular
lithotripsy [20] while
lesions with scores of ≤2 had generally an acceptable
expansion.
It is well established that PCI in CTO is associated
with higher rates of re-occlusion and repeat revascularization compared to conventional PCI. This is
hardly surprising given higher number of stents and a
greater mean stent length required by complex CTO
lesions (Figure 6.3).
It remains controversial whether clinical outcomes
are influenced by the technique used for revascularization. Zhao et al. [21] reviewed the clinical results of
5265 patients at 12–24 months, in terms of restenosis
and other adverse clinical events. They analyzed 12
non-randomized cohort studies and found higher risk
Figure 6.3 Chronic total occlusion of the left anterior
descending in a patient with three vessel disease (a)
Proximal disease of the right coronary artery with
retrograde filling of the left anterior descending. (b)
Severe disease of the proximal left system. (c) Reverse
CART technique was used as follows: Retrograde (Corsair
catheter + Miracle 4.5 wire); Anterograde Over-the-Wire
Balloon 1.5 mm x 12 mm + Confianza Wire. (d) Final
angiogram. (e) OCT LM LA 16:42 mm
LAD wire LCX wire. (g) OCT proximal LAD LA 4.57 mm
Small dissection < 5 mm post-stent. (i) 3D reconstruction of
OCT runs of the proximal LAD. A wire can be seen passing
into the circumflex; note that the side struts of the stent
have been well dilated to leave the ostium open.
2
. (f) OCT Bifurcation
2
. (h)
44 PART II Imaging
of myocardial infarction (MI), target-vessel revascularization (TVR), in-stent restenosis (ISR), and instent re-occlusion in dissection and reentry technique
when compared with classical anterograde wiring.
There are two registries, ISAR-CTO and
CONSISTENT-CTO, which performed follow-up
angiography with optical coherence tomography in
large groups of CTO patients to clarify the possible
mechanism of this phenomenon, not confirmed in
other large registries of DR techniques. CONSISTENTCTO [22] performed 175 optical coherence tomography late after CTO recanalization, with patients
divided nearly equally into DR techniques and no DR
group. More than 90% of stent struts were covered in
both groups without features at risk for stent thrombosis. ISAR-CTO [23] showed a numerically higher
percentage of uncovered struts and significantly more
malapposed struts in the DR technique group.
Another important aspect is to avoid stent strut
malposition which is related to a higher risk of stent
thrombosis. Here again angiography is deficient,
being unable to assess stent strut malapposition,
defined from the lack of full contact between stent
struts and the vessel wall following PCI [24].
It may be present immediately after stent implantation or may develop later and it is very common in
CTO lesions which are usually extensive and have
diffuse calcification and fibrous tissue – these characteristics complicate stent strut apposition and
coverage [25]. The OCT analysis can be used to
identify this complication and decide the correct
balloon diameter for post-dilatation, following
which a further run can be obtained in order to
assess if the desired improvement in strut malapposition has indeed been achieved.
OCT is also useful to define stent under-expansion
that is another powerful predictor of early stent
thrombosis and restenosis after DES implantation.
The percentage of stent or lumen expansion is defined
as MSA or minimal lumen CSA divided by the mean
of the largest proximal and distal reference lumen
CSAs. Maehara et al. [26] showed that OCT may
achieve a comparable degree of stent expansion as that
with IVUS guidance, with a similarly low frequency of
major stent malapposition, tissue prolapse, and edge
dissections.
Stent implantation can also result in vessel wall
injury between the edge of the stent and the adjacent
vessel wall. Deep and large dissections cause a high
rate of stent thrombosis, MACE and new revascularizations. OCT, better than angiography alone, is able to
detect stent edge dissections (SED) that are also not so
clear with IVUS.
Several previous studies investigated the factors
associated with SED after stent implantation including
excessive vessel stretching, calcified or lipidic plaques,
residual plaque eccentricity, stent length, and
ST-elevation MI presentation. In particular, progressive atherosclerotic plaques (lipidic and fibrocalcific
plaques) by OCT and lumen eccentricity are associated with SED. Therefore, operators should avoid
locations with these features as stent landing zones.
Another potential reasons for SED is stent-oversizing
when the stent landing zones were different from
those initially planned. Therefore, the possibility of
stent landing at unplanned zones should be considered when stent length is selected. Finally once the
stent is chosen the appropriate size of post-dilatation
balloon should be decided to correct stent malapposition if present [27].
Conclusion and future perspectives
There is reasonable evidence that IVUS improves midto long-term outcome in the specific setting of CTO
recanalization, a field where IVUS already offers unique
information to correctly engage stumpless occlusions
and to guide reentry from a subintimal path. The role of
OCT before CTO crossing is limited by the need to displace blood to generate images, with the possible
creation of large dissections. If the lesion is entered
anterogradely true-to-true before stenting and in all
cases after stenting, OCT becomes a valid alternative to
IVUS thanks to its superior image resolution which
facilitates the detection of edge damage and applies
automatic algorithms for an objective definition of
calcium burden and to optimize stent expansion.
References
1 Koelbl CO, Nedeljkovic ZS, Jacobs AK. Coronary Chronic
Total Occlusion (CTO): a review. Rev Cardiovasc Med
2018; 19(1): 38–44. doi: 10.31083/j.rcm.2018.01.896.
2 Alasnag M, Weisz G. Intracoronary imaging to guide and
optimize: from seeing is believing to imaging is knowing.
Circ Cardiovasc Interv 2021; 14(10): e011373. doi: 10.1161/
CIRCINTERVENTIONS.121.011373.
3 Ali ZA, Galougahi KK, Mintz GS, Maehara A, Shlofmitz RA,
Mattesini A. Intracoronary optical coherence tomography:
state of the art and future directions. EuroIntervention 2021;
17(2): e105–e123.
4 Prati F, Jenkins MW, Di Giorgio A, Rollins AM.
Intracoronary optical coherence tomography, basic theory
and image acquisition techniques. Int J Cardiovasc Imaging
2011; 27(2): 251–258. doi: 10.1007/s10554-011-9798-1.
5 Fedewa R, Puri R, Fleischman E et al. Artificial intelli-
gence in intracoronary imaging. Curr Cardiol Rep 2020;
22(7): 46. doi: 10.1007/s11886-020-01299-w.
6 Chu M, Jia H, Gutiérrez-Chico JL et al. Artificial intelli-
gence and optical coherence tomography for the automatic
characterisation of human atherosclerotic plaques.
EuroIntervention 2021; 17(1): 41–50.
CHAPTER 6 Optical Coherence Tomography to Guide the Treatment of Chronic Total Occlusions 45
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
7 Furuichi S, Airoldi F, Colombo A. Intravascular ultra-
sound-guided wiring for chronic total occlusion.
Catheter Cardiovasc Interv 2007; 70(6): 856–859. doi:
10.1002/ccd.21219.
Dash D, Li L. Intravascular ultrasound guided percuta-
8
neous coronary intervention for chronic total occlusion.
Curr Cardiol Rev 2015; 11(4): 323–327. doi: 10.2174/157
3403X11666150909105827.
9
Nakatani S, Proniewska K, Pociask E et al. How clini-
cally effective is intravascular ultrasound in interventional cardiology? present and future perspectives.
Expert Rev Med Devices 2013; 10(6): 735–749. doi:
10.1586/17434440.2013.841353.
10
Ali ZA, Maehara A, Généreux P et al. Optical coherence
tomography compared with intravascular ultrasound
and with angiography to guide coronary stent implantation (ILUMIEN III: OPTIMIZE PCI): a randomised controlled trial. Lancet 2016; 388(10060): 2618–2628. doi:
10.1016/S0140-6736(16)31922-5.
Mahadevan K, Cosgrove C, Strange J. Factors influencing
11
stent failure in chronic total occlusion coronary intervention. Interv Cardiol 2021; 16: e27. Published online 2021.
doi: 10.15420/icr.2021.03.
De Felice F, Fiorilli R, Parma A et al. Five-year outcomes
12
in patients with chronic total coronary occlusion treated
with drug-eluting vs bare-metal stents: a case-control
study. Can J Cardiol 2013; 29(8): 945–950. doi: 10.1016/j.
cjca.2012.10.002.
13
Ahn J, Rha SW, Choi B et al. Impact of chronic total
occlusion lesion length on six-month angiographic and
2-year clinical outcomes. PLOS ONE 2018; 13(11):
e0198571. doi: 10.1371/journal.pone.0198571.
14
Räber L, Mintz GS, Koskinas KC et al. Clinical use of
intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous
Cardiovascular Interventions. Eur Heart J 2018; 39(35):
3281–3300. doi: 10.1093/eurheartj/ehy285.
15 Johnson TW, Räber L, Di Mario C et al. Clinical use
of intracoronary imaging. Part 2: acute coronary syndromes, ambiguous coronary angiography findings,
and guiding interventional decision-making: an expert
consensus document of the European Association of
Percutaneous Cardiovascular Interventions: endorsed
by the Chinese Society of Cardiology, the Hong
Kong Society of Transcatheter Endocardiovascular
Therapeutics (HKSTENT) and the Cardiac Society of
Australia and New Zealand. Eur Heart J 2019; 40(31):
2566–2584. doi: 10.1093/eurheartj/ehz332.
16 Cosgrove C, Mahadevan K, Spratt J, McEntegart MB. The
impact of calcium on chronic total occlusion management.
Interv Cardiol 2021; 16: e30. Published online 2021.
doi: 10.15420/icr.2021.01.
17
Karacsonyi J, Karmpaliotis D, Alaswad K et al. Impact of
calcium on chronic total occlusion percutaneous coronary interventions. Am J Cardiol 2017; 120(1): 40–46.
doi: 10.1016/j.amjcard.2017.03.263.
Fujino A, Mintz GS, Matsumura M et al. A new optical
18
coherence tomography-based calcium scoring system to
predict stent underexpansion. EuroIntervention 2018;
13(18): e2182–e2189.
19
Ali ZA, Galougahi KK. Shining light on calcified lesions,
plaque stabilisation and physiologic significance: new
insights from intracoronary OCT. EuroIntervention 2018;
13(18): e2105–e2108.
20
Ali ZA, Nef H, Escaned J et al. Safety and effective-
ness of coronary intravascular lithotripsy for treat
ment of severely calcified coronary stenoses. Circ
Cardiovasc Interv 2019; 12(10): e008434. doi: 10.1161/
CIRCINTERVENTIONS.119.008434.
21 Kaul P, Kandzari DE. Chronic total occlusions. Circ
Cardiovasc Interv 2020; 13(8): e009724. doi: 10.1161/
CIRCINTERVENTIONS.120.009724.
22 Walsh SJ, Hanratty CG, McEntegart M et al. Intra-
vascular healing is not affected by approaches in
contemporary CTO PCI: the CONSISTENT CTO
study. JACC Cardiovasc Interv 2020; 13(12): 1448–1457.
doi: 10.1016/j.jcin.2020.03.032.
Xhepa E, Cassese S, Ndrepepa G et al. Clinical and angio-
23
graphic outcomes of crossing techniques for coronary
chronic total occlusions: the ISAR-CTO registry.
EuroIntervention 2021; 17(8): e656–e663.
24
Izumi D, Miyahara M, Fujimoto N et al. Optical coher-
ence tomography analysis of the stent strut and prediction of resolved strut malapposition at 3 months
after 2nd-generation drug-eluting stent implantation.
Heart Vessels 2016; 31(8): 1247–1256. doi: 10.1007/
s00380-015-0737-2.
25
Jia H, Hu S, Liu H et al. Chronic total occlusion is associ-
ated with a higher incidence of malapposition and
uncovered stent struts: OCT findings at 6 months following DES implantation. Catheter Cardiovasc Interv 2017;
89(S1): 582–591. doi: 10.1002/ccd.26969.
26 Maehara A, Ben-Yehuda O, Ali Z et al. Comparison of
stent expansion guided by optical coherence tomography
versus intravascular ultrasound: the ILUMIEN II study
(observational study of Optical Coherence Tomography
[OCT] in patients undergoing Fractional Flow Reserve
[FFR] and percutaneous coronary intervention). JACC
Cardiovasc Interv 2015; 8(13): 1704–1714. doi: 10.1016/j.
jcin.2015.07.024.
27 Jinnouchi H, Sakakura K, Yanase T et al. Impact of stent
edge dissection detected by optical coherence tomography after current-generation drug-eluting stent
implantation. Widmer RJ, ed. PLOS ONE 2021; 16(11):
e0259693. doi: 10.1371/journal.pone.0259693.
-
III
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
PART III
Wires Technology
Соседние файлы в папке Библиотека им академика М.И. Перельмана