Title
Global Chronic Total Occlusion Crossing Algorithm: JACC State-of-the-Art Review.
Document Type
Article
Publication Date
8-24-2021
Publication Title
Journal of the American College of Cardiology
Keywords
Oregon; Portland
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.
Clinical Institute
Cardiovascular (Heart)
Department
Cardiology
Department
Surgery
Recommended Citation
Wu, Eugene B; Brilakis, Emmanouil S; Mashayekhi, Kambis; Tsuchikane, Etsuo; Alaswad, Khaldoon; Araya, Mario; Avran, Alexandre; Azzalini, Lorenzo; Babunashvili, Avtandil M; Bayani, Baktash; Behnes, Michael; Bhindi, Ravinay; Boudou, Nicolas; Boukhris, Marouane; Bozinovic, Nenad Z; Bryniarski, Leszek; Bufe, Alexander; Buller, Christopher E; Burke, M Nicholas; Buttner, Achim; Cardoso, Pedro; Carlino, Mauro; Chen, Ji-Yan; Christiansen, Evald Hoej; Colombo, Antonio; Croce, Kevin; de Los Santos, Felix Damas; de Martini, Tony; Dens, Joseph; di Mario, Carlo; Dou, Kefei; Egred, Mohaned; Elbarouni, Basem; ElGuindy, Ahmed M; Escaned, Javier; Furkalo, Sergey; Gagnor, Andrea; Galassi, Alfredo R; Garbo, Roberto; Gasparini, Gabriele; Ge, Junbo; Ge, Lei; Goel, Pravin Kumar; Goktekin, Omer; Gonzalo, Nieves; Grancini, Luca; Hall, Allison; Hanna Quesada, Franklin Leonardo; Hanratty, Colm; Harb, Stefan; Harding, Scott A; Hatem, Raja; Henriques, Jose P S; Hildick-Smith, David; Hill, Jonathan M; Hoye, Angela; Jaber, Wissam; Jaffer, Farouc A; Jang, Yangsoo; Jussila, Risto; Kalnins, Artis; Kalyanasundaram, Arun; Kandzari, David E; Kao, Hsien-Li; Karmpaliotis, Dimitri; Kassem, Hussien Heshmat; Khatri, Jaikirshan; Knaapen, Paul; Kornowski, Ran; Krestyaninov, Oleg; Kumar, A V Ganesh; Lamelas, Pablo Manuel; Lee, Seung-Whan; Lefevre, Thierry; Leung, Raymond; Li, Yu; Li, Yue; Lim, Soo-Teik; Lo, Sidney; Lombardi, William; Maran, Anbukarasi; McEntegart, Margaret; Moses, Jeffrey; Munawar, Muhammad; Navarro, Andres; Ngo, Hung M; Nicholson, William; Oksnes, Anja; Olivecrona, Goran K; Padilla, Lucio; Patel, Mitul; Pershad, Ashish; Postu, Marin; Qian, Jie; Quadros, Alexandre; Rafeh, Nidal Abi; Råmunddal, Truls; Prakasa Rao, Vithala Surya; Reifart, Nicolaus; Riley, Robert F; Rinfret, Stephane; Saghatelyan, Meruzhan; Sianos, George; Smith, Elliot; Spaedy, Anthony; Spratt, James; Stone, Gregg; Strange, Julian W; Tammam, Khalid O; Thompson, Craig A; Toma, Aurel; Tremmel, Jennifer A; Trinidad, Ricardo Santiago; Ungi, Imre; Vo, Minh; Vu, Vu Hoang; Walsh, Simon; Werner, Gerald; Wojcik, Jaroslaw; Wollmuth, Jason; Xu, Bo; Yamane, Masahisa; Ybarra, Luiz F; Yeh, Robert W; and Zhang, Qi, "Global Chronic Total Occlusion Crossing Algorithm: JACC State-of-the-Art Review." (2021). Articles, Abstracts, and Reports. 5181.
https://digitalcommons.providence.org/publications/5181
