Modified subintimal plaque modification improving future recanalization of chronic total occlusion percutaneous coronary intervention

Ruo-Fei JIA; Long LI; Yong ZHU; Cheng-Zhi YANG; Shuai MENG; Yang RUAN; Xiao-Jing CAO; Hong-Yu HU; Wei CHEN; Jing NAN; Xiao-Wei XIONG; Jing-Jin LI; Jia-Yu WANG; Ze-Ning JIN

doi:10.11909/j.issn.1671-5411.2020.07.009

Volume 17 Issue 7

Aug. 2020

Turn off MathJax

Article Contents

Article Navigation > Journal of Geriatric Cardiology > 2020 > 17(7): 393-399

Ruo-Fei JIA, Long LI, Yong ZHU, Cheng-Zhi YANG, Shuai MENG, Yang RUAN, Xiao-Jing CAO, Hong-Yu HU, Wei CHEN, Jing NAN, Xiao-Wei XIONG, Jing-Jin LI, Jia-Yu WANG, Ze-Ning JIN. Modified subintimal plaque modification improving future recanalization of chronic total occlusion percutaneous coronary intervention. J Geriatr Cardiol 2020; 17(7): 393-399. doi: 10.11909/j.issn.1671-5411.2020.07.009

Citation:

Ruo-Fei JIA, Long LI, Yong ZHU, Cheng-Zhi YANG, Shuai MENG, Yang RUAN, Xiao-Jing CAO, Hong-Yu HU, Wei CHEN, Jing NAN, Xiao-Wei XIONG, Jing-Jin LI, Jia-Yu WANG, Ze-Ning JIN. Modified subintimal plaque modification improving future recanalization of chronic total occlusion percutaneous coronary intervention. J Geriatr Cardiol 2020; 17(7): 393-399. doi: 10.11909/j.issn.1671-5411.2020.07.009

Citation:

Ruo-Fei JIA, Long LI, Yong ZHU, Cheng-Zhi YANG, Shuai MENG, Yang RUAN, Xiao-Jing CAO, Hong-Yu HU, Wei CHEN, Jing NAN, Xiao-Wei XIONG, Jing-Jin LI, Jia-Yu WANG, Ze-Ning JIN. Modified subintimal plaque modification improving future recanalization of chronic total occlusion percutaneous coronary intervention. J Geriatr Cardiol 2020; 17(7): 393-399. doi: 10.11909/j.issn.1671-5411.2020.07.009

PDF( 2186 KB)

Modified subintimal plaque modification improving future recanalization of chronic total occlusion percutaneous coronary intervention

doi: 10.11909/j.issn.1671-5411.2020.07.009

1.
Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2.
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

More Information

Corresponding author: Ze-Ning JIN, Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, No. 119, South 4^th Ring West Road, Fengtai District, Beijing 100070, China. E-mail: jin_zening@163.com
Received Date: 2020-05-25
Accepted Date: 2020-07-22
Rev Recd Date: 2020-06-16

Available Online: 2020-07-28

Publish Date: 2020-07-28

Abstract

Abstract

Background Subintimal plaque modification (SPM) is often performed to restore antegrade flow and facilitate subsequent lesion recanalization. This study aimed to compare the safety and efficacy of modified SPM with traditional SPM. Methods A total of 1454 consecutive patients who failed a chronic total occlusion percutaneous coronary intervention (CTO PCI) attempt and underwent SPM from January 2015 to December 2019 at our hospital were reviewed retrospectively. Fifty-four patients who underwent SPM finally were included in this study. We analyzed the outcomes of all the patients, and the primary endpoint was recanalization rate, which was defined as Thrombolysis in Myocardial Infarction (TIMI) grades 2-3 flow on angiography 30 to 90 days post-procedure. Results The baseline characteristics were similar between the two groups. In the follow-up, the recanalization rate was noticeably higher in the modified SPM group compared with the traditional SPM group (90.9% vs. 62.5%, P < 0.05). The proposed strategy in the modified group was more aggressive, including a larger balloon size (1.83 ± 0.30 vs. 2.48 ± 0.26 mm, P < 0.05) and longer subintimal angioplasty (0.59 ± 0.16 vs. 0.92 ± 0.12 mm, P < 0.05). Also, the common use of a Stingray balloon and guide catheter extension resulted in improvement of patients in the modified SMP group (12.5% vs. 100%, P < 0.05). Conclusion Modified SPM, which is associated with a high likelihood of successful recanalization, is an effective and safe CTO PCI bail out strategy.
- Chronic total occlusion,
- Recanalization,
- Subintimal plaque modification

^*The first two authors contributed equally to this work.

FullText(HTML)

References(24)

References

[1]	Brilakis ES, Banerjee S, Karmpaliotis D, et al. Procedural outcomes of chronic total occlusion percutaneous coronary intervention: a report from the NCDR (National Cardiovascular Data Registry). JACC Cardiovasc Interv 2015; 8: 245–253. doi: 10.1016/j.jcin.2014.08.014
[2]	Wilson WM, Walsh SJ, Yan AT, et al. Hybrid approach improves success of chronic total occlusion angioplasty. Heart (British Cardiac Society) 2016; 102: 1486–1493. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=ab306d8792545320e468dc752c425f3b
[3]	Sapontis J, Marso SP, Cohen DJ, et al. The outcomes, patient health status, and efficiency in chronic total occlusion hybrid procedures registry: rationale and design. Coron Artery Dis 2017; 28: 110–119. doi: 10.1097/MCA.0000000000000439
[4]	Ellis SG, Burke MN, Murad MB, et al. Predictors of successful hybrid-approach chronic total coronary artery occlusion stenting: an improved model with novel correlates. JACC Cardiovasc Interv 2017; 10: 1089–1098. doi: 10.1016/j.jcin.2017.03.016
[5]	Kinnaird T, Gallagher S, Cockburn J, et al. Procedural success and outcomes with increasing use of enabling strategies for chronic total occlusion intervention. Circ Cardiovasc Interv 2018; 11: e006436. http://cn.bing.com/academic/profile?id=f4037d377ac5a73253ad9b76e7c4446c&encoded=0&v=paper_preview&mkt=zh-cn
[6]	Maeremans J, Walsh S, Knaapen P, et al. The hybrid algorithm for treating chronic total occlusions in Europe: The RECHARGE Registry. J Am Coll Cardiol 2016; 68: 1958– 1970. doi: 10.1016/j.jacc.2016.08.034
[7]	Sapontis J, Salisbury AC, Yeh RW, et al. Early procedural and health status outcomes after chronic total occlusion angioplasty: a report from the OPEN-CTO Registry (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion Hybrid Procedures). JACC Cardiovasc Interv 2017; 10: 1523– 1534. doi: 10.1016/j.jcin.2017.05.065
[8]	Colombo A, Mikhail GW, Michev I, et al. Treating chronic total occlusions using subintimal tracking and reentry: the STAR technique. Catheter Cardiovasc Interv 2005; 64: 407–411. doi: 10.1002/ccd.20307
[9]	Carlino M, Godino C, Latib A, et al. Subintimal tracking and re-entry technique with contrast guidance: a safer approach. Catheter Cardiovasc Interv 2008; 72: 790–796. doi: 10.1002/ccd.21699
[10]	Garibaldi S, Godino C, Carlino M, et al. [Treatment of chronic total coronary occlusions by the subintimal tracking and reentry modified technique. The contrast-guided STAR technique]. G Ital Cardiol (Rome) 2010; 11: 584–569. [Article in Italian]. https: //www.researchgate.net/publication/47632158_Treatment_of_chronic_total_coronary_occlusions_by_the_subintimal_tracking_and_reentry_modified_technique_The_contrast-guided_STAR_technique
[11]	Karmpaliotis D, Michael TT, Brilakis ES, et al. Retrograde coronary chronic total occlusion revascularization: procedural and in-hospital outcomes from a multicenter registry in the United States. JACC Cardiovasc Interv 2012; 5: 1273–1279. doi: 10.1016/j.jcin.2012.06.025
[12]	Brilakis ES, Grantham JA, Thompson CA, et al. The retrograde approach to coronary artery chronic total occlusions: a practical approach. Catheter Cardiovasc Interv 2012; 79: 3–19. doi: 10.1002/ccd.23004
[13]	Manual of coronary chronic total occlusion interventions. A Step-By-Step Approach; Brilakis ES, Ed.; Waltham, MA: Elsevier 2013.
[14]	Mozid AM, Davies JR, Spratt JC. The utility of a guideliner catheter in retrograde percutaneous coronary intervention of a chronic total occlusion with reverse cart-the "capture" technique. Catheter Cardiovasc Interv 2014; 83: 929–932. doi: 10.1002/ccd.25205
[15]	Goleski PJ, Nakamura K, Liebeskind E, et al. Revascularization of coronary chronic total occlusions with subintimal tracking and reentry followed by deferred stenting: Experience from a high-volume referral center. Catheter Cardiovasc Interv 2019; 93: 191–198. doi: 10.1002/ccd.27783
[16]	Hall AB, Brilakis ES. Hybrid 2.0: Subintimal plaque modification for facilitation of future success in chronic total occlusion percutaneous coronary intervention. Catheter Cardiovasc Interv 2019; 93: 199–201. doi: 10.1002/ccd.28088
[17]	Hirai T, Grantham JA, Sapontis J, et al. Impact of subintimal plaque modification procedures on health status after unsuccessful chronic total occlusion angioplasty. Catheter Cardiovasc Interv 2018; 91: 1035–1042. doi: 10.1002/ccd.27380
[18]	Tajti P, Karmpaliotis D, Alaswad K, et al. The hybrid approach to chronic total occlusion percutaneous coronary intervention: update from the PROGRESS CTO Registry. JACC Cardiovasc Interv 2018; 11: 1325–1335. doi: 10.1016/j.jcin.2018.02.036
[19]	Ganz W. The thrombolysis in myocardial infarction (TIMI) trial. N Engl J Med 1985; 313: 1018. http://cn.bing.com/academic/profile?id=16d93851eed906fc97b975a4fade88d5&encoded=0&v=paper_preview&mkt=zh-cn
[20]	Morino Y, Abe M, Morimoto T, et al. Predicting successful guidewire crossing through chronic total occlusion of native coronary lesions within 30 minutes: the J-CTO (Multicenter CTO Registry in Japan) score as a difficulty grading and time assessment tool. JACC Cardiovasc Interv 2011; 4: 213–221. http://cn.bing.com/academic/profile?id=8b597c2d49c74226f1067d73e0d7fd91&encoded=0&v=paper_preview&mkt=zh-cn
[21]	Cutlip DE, Windecker S, Mehran R, et al. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation 2007; 115: 2344–2351. doi: 10.1161/CIRCULATIONAHA.106.685313
[22]	Rao SV, McCoy LA, Spertus JA, et al. An updated bleeding model to predict the risk of post-procedure bleeding among patients undergoing percutaneous coronary intervention: a report using an expanded bleeding definition from the National Cardiovascular Data Registry CathPCI Registry. JACC Cardiovasc Interv 2013; 6: 897–904. doi: 10.1016/j.jcin.2013.04.016
[23]	Wilson WM, Bagnall AJ, Spratt JC. In case of procedure failure: facilitating future success. Interv Cardiol 2013; 5: 521–531. doi: 10.2217/ica.13.54
[24]	Xenogiannis I, Choi JW, Alaswad K, et al. Outcomes of subintimal plaque modification in chronic total occlusion percutaneous coronary intervention. Catheter Cardiovasc Interv. Published online first: Dec 4 2019. Doi: 10.1002/ccd.28614.