Document Server@UHasselt >
Research >
Research publications >

Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/23095

Title: Antegrade wire escalation for chronic total occlusions in coronary arteries: simple algorithms as a key to success
Authors: Maeremans, Joren
Knaapen, Paul
Stuijfzand, Wynand J.
Kayaert, Peter
Pereira, Bruno
Barbato, Emanuele
Dens, Jo
Issue Date: 2016
Citation: Journal of Cardiovascular Medicine, 17(9), p. 680-686
Abstract: Aims Antegrade wire escalation (AWE) remains the method of choice for tackling chronic total occlusions (CTOs), especially for lesions with low J-CTO score. To increase the number of operators which treat CTOs and increase AWE success rates, there is a need for a clear, algorithmic approach. We report the results of a simple AWE algorithm with new guidewire technology in coronary CTOs. Methods Hundred consecutive CTO lesions selected for AWE as the primary strategy were included in five Benelux centers. The algorithm follows a step-wise increase in guidewire tip load. Lesions were categorized according to the J-CTO score. Primary endpoint was successful guidewire crossing. Results No differences in baseline demographics were present between successful and unsuccessful procedures. Overall, in 75% of the lesions AWE resulted in successful crossing. AWE success rates in easy, intermediate, difficult and very difficult CTOs were 83, 86, 71 and 43%, respectively. 46% could be crossed using a soft guidewire only. An additional success of 34 and 60% could be reached with an intermediate and stiff guidewire, respectively. Adding additional techniques resulted in 88% overall success. Procedure and fluoroscopy times, radiation doses and use of contrast were within highly acceptable ranges (67 W 39 min, 27 W 19 min, 1.7 W 1.3 Gy, 264 W 123 ml). Conclusion The algorithm and new wire technologies led to high success rates. AWE as a standalone procedure is highly successful in J-CTO 0-1. Low- and intermediatevolume CTO operators should try to implement a systematic approach in their CTO procedures, especially for lesions with low J-CTO scores. Adding additional techniques further increases these success rates.
URI: http://hdl.handle.net/1942/23095
DOI: 10.2459/JCM.0000000000000340
ISI #: 000383954500007
ISSN: 1558-2027
Category: A1
Type: Journal Contribution
Validation: ecoom, 2017
Appears in Collections: Research publications

Files in This Item:

Description SizeFormat
Published version566.94 kBAdobe PDF
Peer-reviewed author version662.04 kBAdobe PDF

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.