Penetration Of Total Occlusion

Penetration Of Total Occlusion
May 21, 2025
Conversely, more recent occlusions are characterized by a softer cap that is easier to cross. The proximal cap is morphologically classified in three ways: blunt, tapered, and ambiguous. A tapered cap is usually less resistant to penetration than a blunt cap, making it crossable with low penetration force guidewires.
Chronic total occlusions (CTOs), defined as complete coronary artery blockages persisting for over three months, are frequently encountered in up to 25% of coronary angiograms. Although percutaneous coronary intervention (PCI) for CTO remains ...
Find out more about this article on The how and why of... Chronic Total Occlusions
Feb 1, 2025
Apr 14, 2025
Penetration microcatheters are designed for maximum support and crossability in resistant lesions using antegrade approaches. The Tornus penetration catheters are stiff and metallic, designed to enable wiring and crossing of resistant, calcific lesions. Chronic Total Occlusions: A Guide to Recanalization, Third Edition
Abstract Referred to as the "last frontier" in percutaneous coronary intervention, coronary chronic total occlusion (CTO) remains one of the most challenging lesion subsets treated by interventionists.
Apr 26, 2025
An apparatus and method for guided penetration of a chronic total occlusion in a blood vessel are disclosed. The invention is directed to an apparatus that facilitates accurate placement of a drilling tip (31) within a body lumen using ultrasound-based detection (70a) to determine the position of the intravascular catheter relative to the vessel occlusion (222) and vessel walls.
1 day ago
We present a case of calcified chronic total occlusion of the left anterior descending coronary artery with ambiguous cap at the bifurcation with a la…
Severely calcified chronic total occlusions (CTOs) are particularly challenging to recanalize using a conventional wiring approach. Balloon-assisted subintimal entry (BASE) is an effective option to get access to the extraplaque space and set up for antegrade dissection/reentry.
Chronic total occlusion wire shape is described in terms of distal tip curve and secondary curve. Usually, a 40-60º distal tip curve within 1 mm from the tip is made, and a variable secondary curve is made proximal to this.
Find out more about this article on The how and why of... Chronic Total Occlusions - Part Two: Why we treat CTOs the way we do
AbstractWe present a case of calcified chronic total occlusion of the left anterior descending coronary artery with ambiguous cap at the bifurcation with a large diagonal branch, in which intravasc...
PDF | We present a case of calcified chronic total occlusion of the left anterior descending coronary artery with ambiguous cap at the bifurcation with... | Find, read and cite all the research ...
This article reviews the history, indications, techniques and complications of chronic total occlusion percutaneous coronary intervention, including antegrade wiring, dissection re-entry, and retrograde approaches like collateral wiring and controlled antegrade and retrograde tracking.
Jul 1, 2025
May 21, 2025
Keywords chronic total occlusion, coronary collaterals, guidewire, percutaneous coronary intervention Guidewires provide the primary interface between the hands of the percutaneous coronary intervention (PCI) operator and their therapeutic target, the coronary arteries.
We present a case of calcified chronic total occlusion of the left anterior descending coronary artery with ambiguous cap at the bifurcation with a large diagonal branch, in which intravascular lithoplasty balloon was used to modify the calcified proximal cap and facilitate wire crossing. (Level …
Although knuckle wiring expedites chronic total occlusion crossing, it can also complicate the percutaneous coronary intervention strategy irreversibly. Therefore, understanding the various aspects of the knuckle wire technique is a prerequisite in a chronic total occlusion setting.
4 days ago
Sep 21, 2024
Chronic total occlusion (CTO) of the coronaries has long been a known challenge for percutaneous coronary intervention. As the prevalence of peripheral arterial disease escalates, we are increasingly being confronted with complex superficial femoral artery (SFA) and below-the-knee CTO interventions ...
In 39/421 patients the target was a chronic total occlusion and in 5/2460 patients it was a stenotic lesion or recent occlusion. In these 44 consecutive balloon-failures the Tornus completely passed 35 lesions (79.5%) - all but one were successfully followed with a balloon and stent.
This clinical consensus provides guidance on evaluating and managing patients with coronary CTOs, outlining an algorithm for pre-interventional evaluation and the role of PCI versus medical therapy.
Coronary chronic total occlusions (CTO) are frequently identified during coronary angiography and remain the most challenging subset of coronary artery lesions to treat; however, advancements in techniques and materials have greatly improved success ...
Jun 19, 2025
May 21, 2025
It is important to understand that penetration wires can easily exit the vessel architecture, and are therefore not suitable for crossing long CTO segments, especially where the course of the vessel is ambiguous or there is established within-CTO tortuosity. Crossing the Chronic Total Occlusion Body
Continuous advances in the technology of Chronic Total Occlusion (CTO) hardware have led to the development of a wide range of specialty guidewires with increased maneuverability, tip support, torque force, and penetrating power.
Feb 4, 2025
INTRODUCTION onary chronic total occlusion (CTO) remains one of the most challenging lesion subsets for interventionists. Rapid developments in percutaneous coronary intervention (PCI) techniques for CTO over the past decade have increased success rates to over 90%.1 This improvement is attributed to advances
Chronic total occlusion (CTO) intervention constitutes approximately 10-20% of all angioplasty procedures at selected centers. Benefits of CTO revascularization, in addition to relief of angina, include improvement of left ventricular function, reduced risk of major adverse cardiac events and potentially increased survival.
This article provides an overview of dual lumen microcatheters and discusses their clinical applications in complex chronic total occlusions, such as for preserving side branches and parallel wiring techniques.
Chronic total occlusions (CTOs) represent the most complex subset of coronary artery disease and therefore careful planning of CTO percutaneous coronary recanalization (PCI) strategy is of paramount importance aiming to achieve procedural success, and improve patient's safety and post CTO PCI ...
Balloon advancement and dilation through chronic total occlusion segment could be challenging in some cases after successful wire crossing. The purpose of this study was to evaluate efficacy and safety of Tornus catheter (Asahi Intecc; Aichi, Japan) ...
Chronic total occlusions (CTO) represent one of the most challenging lesion subsets in patients undergoing percutaneous coronary intervention (PCI). Historically CTO PCI was associated with significantly lower success rates and increased adverse events compared with PCI for other lesion subsets (1). Recently there has been a rapid and continuous evolution of CTO equipment and techniques that ...
May 21, 2025
Conclusions IVUS guided wire penetration technique was helpful in rechanneling of difficult chronic total occlusion lesions and the procedure was safe.
Dec 1, 2024
Jul 1, 2024
Chronic total occlusions (CTOs) represent the "last frontier" of percutaneous interventions. The main technical challenges lies in crossing the guidewire into the distal true lumen, which is primarily due to three problems: device buckling during initial puncture, inadequate visualization, and the inability to actively navigate through the CTO.
Description: Comprehensive analysis of chronic total occlusion crossing catheters: tip design and penetration force, examining technical considerations, clinical applications, and evidence-based outcomes for healthcare professionals.
Description: Comprehensive analysis of chronic total occlusion crossing catheters: tip design and penetration force, examining technical considerations, clinical applications, and evidence-based outcomes for healthcare professionals.
Description: Comprehensive analysis of chronic total occlusion crossing catheters: tip design and penetration force, examining technical considerations, clinical applications, and evidence-based outcomes for healthcare professionals.
Abstract Antegrade wire escalation is the most easily understood and most widely used chronic total occlusion (CTO) crossing technique and is most appropriate for short occlusions or longer occlusions where a through-and-through microchannel is suspected. Antegrade wire escalation can be divided into seven steps. First, a microcatheter (preferred) or over-the-wire balloon is selected. Second ...
Download scientific diagram | Controlled drilling vs penetration for intimal plaque tracking. from publication: Chronic Total Occlusions - Current Techniques and future directions | Chronic ...
total occlusion (CTO) intervention, there is a void in the literature about the technical aspects of CTO wiring.
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