The Experts below are selected from a list of 516 Experts worldwide ranked by ideXlab platform
Noriyuki Ozawa - One of the best experts on this subject based on the ideXlab platform.
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a new understanding of chronic total occlusion from a novel pci technique that involves a Retrograde approach to the right coronary artery via a septal branch and passing of the Guidewire to a guiding catheter on the other side of the lesion
Catheterization and Cardiovascular Interventions, 2006Co-Authors: Noriyuki OzawaAbstract:Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) by the antegrade approach is sometimes difficult, especially in the right coronary artery (RCA). We performed successful PCls following a Retrograde approach via a septal branch in 2 patients with CTO in RCA. The method involves leading the Retrograde Guidewire outside the body through an opposite guiding catheter after the wire crosses the target lesion. A balloon or stent could then be delivered Retrogradely or antegradely. Even a soft Retrograde wire always crosses the lesion through the true lumen, as confirmed by IVUS. Selecting a suitable collateral, a straighter rather than a larger one, is crucial. Our results do not support the current concept regarding CTOs. Probably, the distal fibrous cap is soft and the proximal one has a thin point that soft wires, even blunt ones, can penetrate easily. The distal penetration point appears to connect to the proximal uncalcified thin point. Many channels seem to spread out from the proximal side, tree-like, within the lesion. In the Retrograde approach, the wire is unlikely to enter these branch channels. The results suggest that PCI by the Retrograde approach may be effective for treating CTOs of RCA.
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a new understanding of chronic total occlusion from a novel pci technique that involves a Retrograde approach to the right coronary artery via a septal branch and passing of the Guidewire to a guiding catheter on the other side of the lesion
Catheterization and Cardiovascular Interventions, 2006Co-Authors: Noriyuki OzawaAbstract:Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) by the antegrade approach is sometimes difficult, especially in the right coronary artery (RCA). We performed successful PCls following a Retrograde approach via a septal branch in 2 patients with CTO in RCA. The method involves leading the Retrograde Guidewire outside the body through an opposite guiding catheter after the wire crosses the target lesion. A balloon or stent could then be delivered Retrogradely or antegradely. Even a soft Retrograde wire always crosses the lesion through the true lumen, as confirmed by IVUS. Selecting a suitable collateral, a straighter rather than a larger one, is crucial. Our results do not support the current concept regarding CTOs. Probably, the distal fibrous cap is soft and the proximal one has a thin point that soft wires, even blunt ones, can penetrate easily. The distal penetration point appears to connect to the proximal uncalcified thin point. Many channels seem to spread out from the proximal side, tree-like, within the lesion. In the Retrograde approach, the wire is unlikely to enter these branch channels. The results suggest that PCI by the Retrograde approach may be effective for treating CTOs of RCA. © 2006 Wiley-Liss, Inc.
Subhash Banerjee - One of the best experts on this subject based on the ideXlab platform.
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ping pong guide catheter technique for Retrograde intervention of a chronic total occlusion through an ipsilateral collateral
Catheterization and Cardiovascular Interventions, 2011Co-Authors: Emmanouil S. Brilakis, Aaron J Grantham, Subhash BanerjeeAbstract:We report a novel technique for performing Retrograde interventions on a coronary chronic total occlusion through an ipsilateral collateral. Two guiding catheters are used to engage the target coronary artery, one to advance to the Retrograde Guidewire and the other to externalize the Retrograde Guidewire and antegrade wiring. Engagement of the target coronary artery is alternating between the antegrade and the Retrograde guide catheter in a “ping-pong” fashion, enabling lesion crossing and equipment delivery. © 2011 Wiley-Liss, Inc.
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bilateral knuckle technique and stingray re entry system for Retrograde chronic total occlusion intervention
Journal of Invasive Cardiology, 2011Co-Authors: Emmanouil S. Brilakis, Neeraj Badhey, Subhash BanerjeeAbstract:We report a novel technique for Retrograde chronic total occlusion intervention, in which the lesion is crossed by forming and advancing a "knuckle" in both the antegrade and Retrograde Guidewire, followed by reentry in the true lumen by using the Stingray re-entry system.
Emmanouil S. Brilakis - One of the best experts on this subject based on the ideXlab platform.
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ping pong guide catheter technique for Retrograde intervention of a chronic total occlusion through an ipsilateral collateral
Catheterization and Cardiovascular Interventions, 2011Co-Authors: Emmanouil S. Brilakis, Aaron J Grantham, Subhash BanerjeeAbstract:We report a novel technique for performing Retrograde interventions on a coronary chronic total occlusion through an ipsilateral collateral. Two guiding catheters are used to engage the target coronary artery, one to advance to the Retrograde Guidewire and the other to externalize the Retrograde Guidewire and antegrade wiring. Engagement of the target coronary artery is alternating between the antegrade and the Retrograde guide catheter in a “ping-pong” fashion, enabling lesion crossing and equipment delivery. © 2011 Wiley-Liss, Inc.
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bilateral knuckle technique and stingray re entry system for Retrograde chronic total occlusion intervention
Journal of Invasive Cardiology, 2011Co-Authors: Emmanouil S. Brilakis, Neeraj Badhey, Subhash BanerjeeAbstract:We report a novel technique for Retrograde chronic total occlusion intervention, in which the lesion is crossed by forming and advancing a "knuckle" in both the antegrade and Retrograde Guidewire, followed by reentry in the true lumen by using the Stingray re-entry system.
Shigeru Saito - One of the best experts on this subject based on the ideXlab platform.
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progress in the Retrograde approach for chronic total coronary artery occlusion a case with successful angioplasty using cart and reverse anchoring techniques 3 years after failed pci via a Retrograde approach
Catheterization and Cardiovascular Interventions, 2008Co-Authors: Jyunya Matsumi, Shigeru SaitoAbstract:After the introduction of the Retrograde approach in percutaneous coronary intervention for chronic total occlusion (CTO), different kinds of strategies and techniques have been developed in order to achieve final success. However, it has not been fully demonstrated whether these strategies and techniques can really improve the final result. We observed one case, for which the initial attempt of the Retrograde approach for a CTO lesion was unsuccessful despite the successful approach of a Retrograde Guidewire to the lesion, and with the second Retrograde approach 3 years later being eventually successful by using various kinds of strategies and techniques. This case clearly demonstrates how the final success through the Retrograde approach can be achieved by using a combination of the improved strategies and techniques for CTO lesions. © 2008 Wiley-Liss, Inc.
Osamu Katoh - One of the best experts on this subject based on the ideXlab platform.
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procedural and in hospital outcomes after percutaneous coronary intervention for chronic total occlusions of coronary arteries 2002 to 2008 impact of novel Guidewire techniques
Jacc-cardiovascular Interventions, 2009Co-Authors: Sudhir Rathore, Hitoshi Matsuo, Mitsuyasu Terashima, Yoshihisa Kinoshita, Masashi Kimura, Etsuo Tsuchikane, Kenya Nasu, Mariko Ehara, Yasushi Asakura, Osamu KatohAbstract:The aim of this study was to examine the procedural success and in-hospital outcomes after percutaneous coronary intervention (PCI) for chronic total occlusions in the current era during contemporary practice. The technique of PCI has improved over time with the introduction of novel equipment and Guidewire crossing techniques. However, there is limited data available from contemporary practice in the recent years. We evaluated the procedural and in-hospital outcomes in a consecutive series of 904 procedures performed at Toyohashi Heart Center for PCI of chronic total occlusions of >3 months in duration. Technical and procedural success was achieved in 87.5% and 86.2%, respectively. In-hospital major adverse cardiac events occurred in only 1.9% of the patients. Single antegrade wire was the predominant strategy for Guidewire crossing; however, Retrograde Guidewire crossing was used in 7.2% of the cases and controlled antegrade and Retrograde subintimal tracking in 9.9% of the cases as the final strategy. Logistic regression analysis identified severe tortuosity and moderate-to-severe calcification as significant predictors of procedural failure. This is the first reported large series of patients undergoing PCI for chronic total occlusion with improved wire crossing techniques. We have reported high success rates in recent years and very low complication rates despite the use of more aggressive devices and techniques.