Author(s)

Joren Maeremans, Philippe Selleslagh, Luigi Di Serafino, Emanuele Barbato, Joseph Dens

Department of Cardiology, Onze-Lieve-Vrouw Ziekenhuis, Aalst, Belgium.
Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.

To improve the success rates of chronic total occlusion (CTO) intervention, a large range of CTO-dedicated guidewires (GWs), devices and techniques have been developed. However, such an abundant choice of materials confuses inexperienced operators. Therefore, the usefulness of a simple antegrade treatment algorithm with a limited set of GWs, for easy to intermediate lesions, was investigated. Between November 2011 and March 2013, 105 patients were included, who underwent CTO PCI following the algorithm. Lesions were classified according to the Multicenter CTO Registry of Japan score. Overall technical success was achieved in 77%. Study endpoint was successful GW crossing within 30 min and was reached in 57%. High success rates were achieved in easy (81%) and intermediate (64%) lesion types. In both types, a soft wire could successfully cross in 57% and 51% respectively, with the Fielder XT^® (Asahi Intecc Co.) capable of crossing most commonly (90%). The proposed treatment algorithm simplifies the percutaneous treatment of easy to intermediate CTO lesions. However, it merits further evaluation, especially for operators/centers who perform a low to intermediate amount of CTO PCI.

Percutaneous Coronary Intervention; Chronic Total Occlusion; Interventional Cardiology; Coronary Angioplasty; Guidewires

Maeremans, J. , Selleslagh, P. , Serafino, L. , Barbato, E. and Dens, J. (2013) Chronic total occlusions for intermediate volume operators: An antegrade step-up algorithm allows high success in easy and intermediate difficult CTO lesions. World Journal of Cardiovascular Diseases, 3, 536-542. doi: 10.4236/wjcd.2013.39085.