June 2008

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Volume 20 Issue 6
RAO caudal projection showing a total LAD occlusion after giving off a large diagonal branch.
Novel Use of Twin-Pass Catheter in Successful Recanalization of
a Chronic Coronary Total Occlusion
The exact incidence of chronic total occlusions (CTOs) during routine coronary angiography is not well defined. It has been reported in the literature that CTOs are encountered in approximately one-third of diagnostic cardiac catheterizations.1 Anoth…
Diagnostic angiogram of the left coronary artery in the right anterior oblique cranial view showed a long chronic total occlusion of the mid-left anterior descending artery with the ipsilateral intraseptal collateral vessel.
Retrograde Recanalization of a Left Anterior Descending
Chronic Total Occlusion via an Ipsilateral Intraseptal Collateral
Successful recanalization and percutaneous revascularization of coronary arteries with chronic total occlusions (CTO) is one of the last frontiers in percutaneous coronary interventions (PCI). Successful CTO treatment is associated with reduced angin…
The TandemHeart pump acts with the THTC-EF cannula to unload the left side of the heart. (Image provided courtesy of CardiacAssist Inc.)
Single-Center Experience with the TandemHeart Percutaneous
Ventricular Assist Device to Support Patients undergoing
High-Risk
Percutaneous coronary intervention (PCI) offers an alternative form of therapy for patients considered to be at high risk for coronary artery bypass graft surgery (CABG). PCI is associated with substantial morbidity and mortality in the presence of s…
Flow-limiting in-stent restenosis of the distal LAD (28º cranial, 22º RAO view).
Management of Distal Coronary Perforations
Coronary artery perforation (CAP) is an uncommon, yet potentially devastating, complication of percutaneous coronary interventions (PCI).1 Early reports of this catastrophic complication date back to the early 1980s.2 In a recent review of 6,245 pati…
Severe disease in the mid-left anterior descending artery and obtuse marginal branch.
Very Late Sirolimus-Eluting Stent Displaced Fracture in the
Mid-Left Anterior Descending Artery
Case Report. A 66-year-old female was admitted in March 2005 with non-ST-segment elevation myocardial infarction (NSTEMI). She had a prior history of hypertension, dyslipidemia and paroxysmal supraventricular tachycardia (SVT). Her coronary angiogram…
Figure 1. (A) Left ventriculography in a LAO cranial projection demonstrating fenestrated perimembranous ventricular septal defect (Arrow).
Late Complete Heart Block in an Adult Patient undergoing
Percutaneous Ventricular Septal Defect Closure
Transcatheter closure of ventricular septal defects has emerged as an attractive therapeutic modality, with excellent procedural and intermediate hemodynamic outcomes. While experience with this technique is relatively limited, longerterm follow up i…
Delivery system (A: scheme, B: angiography). The delivery system is delivered into the coronary artery over the 0.014 inch guidewire. Using the 5 Fr guide catheter with a 0.035 inch guidewire, the material (bone chips with absorbable sponge) is pushed out
Development of a Novel Calcified Total Occlusion Model in
Porcine Coronary Arteries
Chronic total occlusion (CTO) represents 10–20% of all angioplasty cases and remains a challenge for interventional cardiologists.1–3 CTOs are associated with significant angina, impaired left ventricular function and poor long-term outcomes.4 Althou…
The presence of a stem of patent vessel longer than 10mm, with a tapering configuration or a visible track and has no branches originating within 5mm of the occlusion or e v idence of calcification on fluoroscopy is classified as a CTO with an “AO” grade.
A Universal Classification System for Chronic Total Occlusions
Chronic total occlusions (CTOs) present one of the most challenging obstacles to interventional cardiologists in the current era. Technical difficulties associated with percutaneous coronary intervention (PCI) of CTOs are reflected by lower success r…
(a) Simultaneous antegrade and retrograde angiography of the CTO in the middle LCX; RAO caudal projection. (b) Antegrade guidewire embedded into the subintimal space with its entry at the proximal cap. (c) Both the retrograde and antegrade wires in their
Improvement of Regional Ischemia after Successful Percutaneous
Intervention of Bypassed Native Coronary Chronic Total
Occlusio
During angiography, when the saphenous vein graft (SVG) bypassing a chronic total occlusion (CTO) in a coronary artery is found to be patent without significant obstructive disease, conventional wisdom would suggest adequate distal perfusion supply a…
Demographics and clinical characteristics.
Utilization of GP IIb/IIIa Inhibitors in Peripheral Percutaneous
Interventions: Current Applications and In-Hospital Outcomes
Thrombus is highly prevalent in patients with peripheral arterial disease, particularly those with recent symptoms and occluded or subtotally occluded vessels. In a prospective registry of 17 consecutive patients with recent (< 6 months) symptoms…