Manual of Coronary Chronic Total Occlusion Interventions: A Step-by-Step Approach is a practical, easy to read reference for coronary chronic total occlusion interventions (CTO). Written by recognized national and international experts in the field, this reference compiles the steps necessary to preform, pitfalls to watch out for, and troubleshooting needed for coronary chronic total occlusion interventions (CTO).
- BMA Medical Book Awards 2014 - Highly Commended, Cardiology,2014,British Medical Association
- A practical, case-oriented and easy to read reference with illustrations and step-by-step guidance for coronary chronic total occlusion interventions (CTO).
- Includes expert guidance reviewed by leaders in the field with both large clinical experience with high success rates and extensive experience proctoring CTOs in multiple clinical centers.
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List of Contributors
1. CTO Interventions: Definition, Prevalence, Indications, Guidelines
1.1 CTO Definition
1.2 Prevalence of CTOs
1.3 Indications and Potential Clinical Benefits of CTO PCI
1.4 Guidelines for CTO PCI
1.5 Appropriateness Use Criteria in CTO PCI
1.6 Contraindications to CTO PCI
1.7 Summary and Conclusions
2.2 Guide Catheters
2.5 Dissection/Re-Entry Equipment
2.7 "Uncrossable-Undilatable Lesion Equipment
2.8 Intravascular Ultrasound
2.9 Complication Management Equipment
2.10 Radiation Protection
2.11 The "CTO cart
3. The Basics: Timing, Dual Injection, Studying the Lesion, Access, Anticoagulation, Guide Support, Trapping
3.2 Dual Injection
3.3 Studying the Lesion
3.4 Vascular Access
3.6 Techniques to Increase Guide Catheter Support (Large Bore Guide, Active Guide Support, Guide Catheter Extensions, Anchor Techniques
4. Antegrade Wire Escalation: The Foundation of CTO PCI
4.1 Special Situations
5. Antegrade Dissection/Re-entry
5.1 Knuckle Wire
5.3 Stingray-Based Re-entry
5.4 Wire-Based Re-entry
6. The Retrograde Approach
6.1 Historical Perspective
6.2 Advantages of the Retrograde Approach
6.3 Special Equipment
6.4 Step-by-Step Description of the Procedure
6.5 Retrograde True Lumen Puncture
6.6 Retrograde Dissection/Re-entry
6.7 Antegrade Crossing
6.8 Special Retrograde CTO PCI Scenarios
7. Putting it all Together: The "Hybrid Approach
7.1 Description of the "Hybrid Algorithm
7.2 Impact of the "Hybrid Approach
8. "Balloon Uncrossable CTOs
8.1 Simultaneous Use of Strategies
9. "Balloon Undilatable CTOs
9.1 Special Case Scenario: Stented "Balloon Undilatable Lesions
10. Radiation Management During CTO PCI
10.1 Why is Radiation Management Important?
10.2 Essentials of Radiation Dose Management
11. Stenting of CTO Lesions
11.1 Stent Type
11.2 Stent Optimization
11.3 Antiplatelet Therapy After CTO Stenting
12.1 Acute Complications
12.2 Long-Term Complications
13. How to Build a Successful CTO Program
Appendix 1. Equipment Commonly Utilized in CTO Interventions
Appendix 2. Commonly Used Acronyms in CTO Interventions
Emmanouil S. Brilakis, MD, PhD, FACC, FAHA, FESC, FSCAI
Dr. Brilakis is Director of the Center for Complex Coronary Interventions at the Minneapolis Heart Institute and adjunct Professor of Medicine at the University of Texas Southwestern Medical School. After graduating from Lycee Leonin de Patissia, Dr. Brilakis received his medical degree from the National Kapodistrian University of Athens, Greece. He trained in Internal Medicine, Cardiovascular Diseases and Interventional Cardiology at the Mayo Clinic. He also completed a Masters in Clinical Research at the Mayo Clinic and a PhD in Clinical Research at the National Kapodistrian University of Athens, Greece. He served as Director of the VA North Texas Healthcare System Cardiac Catheterization Laboratories from 2004 to 2016.
Dr. Brilakis leads a large clinical trial group investigating treatment of chronic total occlusions, prevention and treatment of saphenous vein graft disease, prevention and management of complications, intracoronary imaging, antiplatelet treatment optimization post coronary stenting, radiation safety in the catheterization laboratory, and implementation of novel technologies in healthcare.
He is Associate Editor for Circulation and on the editorial board of several other journals, a Trustee of the Society of Cardiovascular Angiography and Interventions and on the Board of Directors of the Cardiovascular Innovations Foundation. He has authored or co-authored over 450 manuscripts and receives funding from the Department of Veterans Affairs and industry. He and is lecturing and proctoring at several institutions in the United States and abroad.