Global Chronic Total Occlusion Crossing Algorithm: JACC State-of-the-Art Review
(2021) In Journal of the American College of Cardiology 78(8). p.840-853- Abstract
- 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)... (More)
- 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. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/5eba31b3-8bbc-4527-af9b-3adb02a9fd6a
- author
- Wu, Eugene B. ; Olivecrona, Göran LU and Zhang, Qi
- author collaboration
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of the American College of Cardiology
- volume
- 78
- issue
- 8
- pages
- 14 pages
- publisher
- Elsevier
- external identifiers
-
- scopus:85112399031
- pmid:34412818
- ISSN
- 0735-1097
- DOI
- 10.1016/j.jacc.2021.05.055
- language
- English
- LU publication?
- yes
- id
- 5eba31b3-8bbc-4527-af9b-3adb02a9fd6a
- date added to LUP
- 2021-09-14 13:00:12
- date last changed
- 2022-04-27 03:53:23
@article{5eba31b3-8bbc-4527-af9b-3adb02a9fd6a,
abstract = {{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.}},
author = {{Wu, Eugene B. and Olivecrona, Göran and Zhang, Qi}},
issn = {{0735-1097}},
language = {{eng}},
number = {{8}},
pages = {{840--853}},
publisher = {{Elsevier}},
series = {{Journal of the American College of Cardiology}},
title = {{Global Chronic Total Occlusion Crossing Algorithm: JACC State-of-the-Art Review}},
url = {{http://dx.doi.org/10.1016/j.jacc.2021.05.055}},
doi = {{10.1016/j.jacc.2021.05.055}},
volume = {{78}},
year = {{2021}},
}