Global Chronic Total Occlusion Crossing Algorithm

• Autor(a) principal: Wu, EB
• Data de Publicação: 2021
• Outros Autores: Brilakis, ES, Mashayekhi, K, Tsuchikane, E, Alaswad, K, Araya, M, Avran, A, Azzalini, L, Babunashvili, AM, Bayani, B, Behnes, M, Bhindi, R, Boudou, N, Boukhris, M, Bozinovic, NZ, Bryniarski, L, Bufe, A, Buller, CE, Burke, MN, Buttner, A, Cardoso, P, Carlino, M, Chen, JY, Christiansen, EH, Colombo, A, Croce, K, de los Santos, FD, de Martini, T, Dens, J, di Mario, C, Dou, K, Egred, M, Elbarouni, B, ElGuindy, A, Escaned, J, Furkalo, S, Gagnor, A, Galassi, AR, Garbo, R, Gasparini, G, Ge, J, Ge, L, Goel, P, Goktekin, O, Gonzalo, N, Grancini, L, Hall, A, Hanna Quesada, F, Hanratty, C, Harb, S, Harding, S., Hatem, R, Henriques, J, Hildick-Smith, D, Hill, J, Hoye, A, Jaber, W, Jaffer, F, Jang, Y, Jussila, R, Kalnins, A, Kalyanasundaram, A, Kandzari, D, Kao, HL, Karmpaliotis, D, Kassem, HH, Khatri, J, Knaapen, P, Kornowski, R, Krestyaninov, O, Kumar, A, Lamelas, P, Lee, SW, Lefevre, T, Leung, R, Li, Y, Lim, ST, Lo, S, Lombardi, W, Maran, A, McEntegart, M, Moses, J, Munawar, M, Navarro, A, Ngo, H, Nicholson, W, Oksnes, A, Olivecrona, G, Padilla, L, Patel, M, Pershad, A, Postu, M, Qian, J, Quadros, A, Rafeh, NA, Råmunddal, T, Prakasa Rao, VS, Reifart, N, Riley, RF, Rinfret, S, Saghatelyan, M, Sianos, G, Smith, E, Spaedy, A, Spratt, J, Stone, G, Strange, JW, Tammam, KO, Thompson, CA, Toma, A, Tremmel, JA, Trinidad, RS, Ungi, I, Vo, M, Vu, VH, Walsh, S, Werner, G, Wojcik, J, Wollmuth, J, Xu, B, Yamane, M, Ybarra, LF, Yeh, RW, Zhang, Q
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.26/37429
• topic: Algoritmos; Oclusão Coronária; Algorithms; Coronary Occlusion

The authors developed a global chronic total occlusion crossing algorithm following 10 steps: 1) dual angiography; 2) careful angiographic review focusing on proximal cap morphology, occlusion segment, distal vessel quality, and collateral circulation; 3) approaching proximal cap ambiguity using intravascular ultrasound, retrograde, and move-the-cap techniques; 4) approaching poor distal vessel quality using the retrograde approach and bifurcation at the distal cap by use of a dual-lumen catheter and intravascular ultrasound; 5) feasibility of retrograde crossing through grafts and septal and epicardial collateral vessels; 6) antegrade wiring strategies; 7) retrograde approach; 8) changing strategy when failing to achieve progress; 9) considering performing an investment procedure if crossing attempts fail; and 10) stopping when reaching high radiation or contrast dose or in case of long procedural time, occurrence of a serious complication, operator and patient fatigue, or lack of expertise or equipment. This algorithm can improve outcomes and expand discussion, research, and collaboration.