Manual of Chronic Total Occlusion Percutaneous Coronary Interventions
A Step-by-Step Approach
- 3rd Edition - February 7, 2023
- Imprint: Academic Press
- Author: Emmanouil Brilakis
- Language: English
- Paperback ISBN:9 7 8 - 0 - 3 2 3 - 9 1 7 8 7 - 2
- eBook ISBN:9 7 8 - 0 - 3 2 3 - 9 1 8 0 4 - 6
Manual of Chronic Total Occlusion Percutaneous Coronary Interventions: A Step-by-Step Approach, Third Edition is a practical reference for coronary chronic total occlusion… Read more
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Request a sales quoteManual of Chronic Total Occlusion Percutaneous Coronary Interventions: A Step-by-Step Approach, Third Edition is a practical reference for coronary chronic total occlusion (CTO) percutaneous coronary interventions (PCI). Written by recognized national and international experts in the field, this reference compiles the steps necessary to preform, what pitfalls to watch out for, and how to troubleshoot tactics. Written to bring a practical approach, this book is perfect for interventional cardiologists, interventional and general cardiology fellows, cardiology researchers, physicians, cardiac catheterization laboratory personnel, technical staff, industry professionals and everyone else interested in understanding the cutting-edge and rapidly evolving field of CTO PCI.
In this new edition, new figures, images and algorithms have been developed to reflect the updates in CTO PCI during the past few years. In addition, this update links to approximately 200 CTO PCI cases that are accessible for free and hosted by the author on YouTube, with monthly updates on new cases. The structure of the book is completely revised to align it with the recently published Manual of Percutaneous Coronary Interventions (published in Oct 2020, also by Dr. Brilakis under the same imprint Academic Press).
- Provides step-by-step guidance on every technique used in coronary chronic total occlusion interventions using color figures and diagrams
- Presents expert guidance by leaders in the field with both large clinical experience and extensive experience proctoring CTOs in multiple clinical centers
- Contains links to approximately 200 YouTube videos that illustrate the concepts and techniques presented in the text
- Includes the latest clinical experience, equipment, techniques and publications
Cardiology researchers, physicians, cardiac catheterization laboratory personnel, technical staff, and industry professionals
- Cover image
- Title page
- Table of Contents
- Copyright
- Dedication
- List of contributors
- Manual of CTO PCI cases
- Manual of PCI cases
- Prologue
- Introduction
- 1 Chronic total occlusion definition
- 2 Prevalence of chronic total occlusions
- 3 Outline of the Manual of CTO PCI
- Part A: The steps
- Chapter 1. Planning
- Abstract
- 1.1 Planning
- 1.2 Monitoring
- 1.3 Pharmacology
- 1.4 Access
- 1.5 Engagement
- 1.6 Angiography
- 1.7 Determine target lesion(s)
- 1.8 Lesion wiring
- 1.9 Lesion preparation
- 1.10 Stenting
- 1.11 Arterial closure
- 1.12 Physiology
- 1.13 Imaging
- 1.14 Hemodynamic support
- References
- Chapter 2. Monitoring
- Abstract
- 2.1 Patient
- 2.2 Electrocardiogram
- 2.3 Pressure waveform
- 2.4 Oxygen saturation
- 2.5 Radiation dose—X-ray system and shield positioning
- 2.6 Contrast volume
- 2.7 Access site
- 2.8 Medication administration (anticoagulation—ACT, sedation, other medications)
- 2.9 Operator and team performance
- 2.10 Cath lab environment
- 2.11 Sterile field and equipment
- 2.12 Equipment position within the body
- References
- Chapter 3. Medications
- 3.1 Sedatives and analgesics
- 3.2 Vasodilators
- 3.3 Contrast media
- 3.4 Anticoagulants
- 3.5 Antiplatelet agents
- 3.6 Vasopressors and inotropes
- 3.7 Antiarrhythmics
- References
- Chapter 4. Access
- Abstract
- 4.1 Dual (or triple) arterial access
- 4.2 Femoral versus radial access
- 4.3 Femoral access
- 4.4 Radial access
- References
- Chapter 5. Coronary and graft engagement
- Abstract
- Reference
- Chapter 6. Coronary angiography and coronary computed tomography angiography
- Abstract
- 6.1 Dual injection
- 6.2 Studying the lesion
- 6.3 Chronic total occlusion percutaneous coronary intervention angiographic scores
- 6.4 Use of coronary computed tomography angiography
- References
- Chapter 7. Selecting target lesion(s)
- Abstract
- 7.1 Stable angina
- 7.2 Acute coronary syndromes (Fig. 7.7)
- 7.3 Percutaneous coronary intervention timing
- 7.4 Percutaneous coronary intervention lesion sequence selection
- References
- Chapter 8. Wiring
- Abstract
- Section 8.1. CTO Wiring classification/definitions
- 8.1.1 CTO crossing strategies definitions
- 8.1.2 CTO crossing strategies classification and terminology
- Section 8.2. Antegrade wiring
- 8.2.1 Antegrade wiring: when?
- 8.2.2 Antegrade wiring: how?
- Section 8.3. Antegrade dissection and reentry (ADR)
- 8.3.1 Antegrade dissection/reentry (ADR) nomenclature
- 8.3.2 Antegrade dissection/reentry: when?
- 8.3.3 Antegrade dissection/reentry: preparation
- 8.3.4 Antegrade dissection
- 8.3.5 Antegrade reentry
- Section 8.4. Retrograde
- 8.4.1 Historical perspective
- 8.4.2 Advantages of the retrograde approach
- 8.4.3 Special equipment
- 8.4.4 Step-by-step description of the procedure
- 8.4.5 Contemporary role of the retrograde approach
- Section 8.5. Crossing algorithms
- 8.5.1 Historical perspectives
- 8.5.2 Steps of the global CTO crossing algorithm
- Chapter 9. Lesion preparation
- Abstract
- 9.1 Goal
- 9.2 When is lesion preparation needed?
- 9.3 How to prepare a chronic total occlusion
- References
- Chapter 10. Stenting
- Abstract
- 10.1 When to stent?
- 10.2 How to stent
- 10.3 Long-term outcomes after stenting for CTO PCI
- References
- Chapter 11. Access closure
- Abstract
- References
- Chapter 12. Coronary physiology
- Abstract
- 12.1 When to do coronary physiology during chronic total occlusion percutaneous coronary intervention?
- References
- Chapter 13. Intravascular imaging for CTO PCI
- Abstract
- 13.1 Intravascular imaging modality selection
- 13.2 Intravascular imaging for CTO crossing
- 13.3 Intravascular imaging for PCI optimization
- 13.4 Frequency of intravascular imaging for CTO PCI
- References
- Chapter 14. Hemodynamic support for chronic total occlusion percutaneous coronary intervention
- Abstract
- 14.1 Hemodynamic support: when and what device
- 14.2 Hemodynamic support devices
- References
- Part B: Complex subgroups
- Chapter 15. Ostial chronic total occlusions
- Abstract
- 15.1 Aorto-ostial chronic total occlusions
- 15.2 Branch ostial chronic total occlusions
- References
- Chapter 16. Bifurcations and CTOs
- Abstract
- 16.1 Proximal cap ambiguity
- 16.2 Ostial circumflex and ostial left anterior descending artery CTOs
- 16.3 Bifurcation at the proximal cap
- 16.4 Bifurcation in the CTO body
- 16.5 Bifurcation at the distal cap
- References
- Chapter 17. Left main chronic total occlusions
- Abstract
- 17.1 Aorto-ostial left main chronic total occlusions
- 17.2 Treatment of the bifurcation
- 17.3 Risk of hemodynamic collapse
- References
- Chapter 18. CTO PCI in the prior CABG patient
- Abstract
- 18.1 Challenges of CTO PCI in prior CABG patients
- 18.2 Selecting the target vessel in prior CABG patients
- 18.3 Retrograde approach through saphenous vein grafts
- 18.4 Retrograde approach through internal mammary grafts
- 18.5 Saphenous vein graft CTOs
- 18.6 Saphenous vein graft aneurysms
- 18.7 Coronary perforation in prior CABG patients
- References
- Chapter 19. CTO PCI in heavily calcified vessels
- Abstract
- 19.1 Difficulty crossing the proximal or distal CTO cap (wire impenetrable cap)
- 19.2 Crossing the occlusion
- 19.3 Reentry into the distal true lumen
- 19.4 Equipment delivery
- 19.5 Stent expansion
- References
- Chapter 20. Chronic total occlusion percutaneous coronary intervention in patients presenting with acute coronary syndromes
- Abstract
- References
- Chapter 21. Multiple chronic total occlusions—Prior chronic total occlusion percutaneous coronary intervention failure
- Abstract
- 21.1 Multiple chronic total occlusions
- 21.2 Prior chronic total occlusion percutaneous coronary intervention failure
- References
- Chapter 22. Percutaneous coronary intervention of in-stent chronic total occlusions
- Abstract
- 22.1 Approach to in-stent chronic total occlusions
- 22.2 Challenges associated with percutaneous coronary intervention of in-stent chronic total occlusions
- References
- Chapter 23. Balloon uncrossable and balloon undilatable CTOs
- Abstract
- 23.1 Balloon uncrossable lesions
- 23.2 Balloon undilatable CTOs
- References
- Chapter 24. Complex patient subgroups
- Abstract
- 24.1 Prior transcatheter aortic valve replacement (TAVR) patients
- 24.2 Heart failure patients
- References
- Part C: Complications
- Chapter 25. Acute vessel closure
- Abstract
- 25.1 Maintain guidewire position
- 25.2 Determine the cause of acute vessel closure and treat accordingly
- 25.3 Hemodynamic support
- References
- Chapter 26. Perforation
- Abstract
- 26.1 Perforation classification
- 26.2 General treatment of perforations
- 26.3 Large vessel perforation
- 26.4 Distal vessel perforation
- 26.5 Collateral vessel perforation
- 26.6 Perforation in patients with prior coronary artery bypass graft surgery carries very high risk
- References
- Chapter 27. Equipment loss and entrapment
- Abstract
- 27.1 Stent loss or entrapment
- 27.2 Guidewire entrapment and fracture
- 27.3 Balloon entrapment or shaft fracture
- 27.4 Microcatheter entrapment or fracture
- 27.5 Rotablator burr entrapment
- References
- Chapter 28. Other complications: hypotension, radiation skin injury, contrast-induced acute kidney injury
- Abstract
- 28.1 Hypotension
- 28.2 Radiation skin injury
- 28.3 Contrast-induced acute kidney injury (CI-AKI)
- References
- Chapter 29. Vascular access complications
- Abstract
- Reference
- Part D: Equipment
- Chapter 30. Equipment
- Abstract
- Introduction
- 30.1 Sheaths
- 30.2 Catheters
- 30.3 Guide catheter extensions
- 30.4 Support catheters
- 30.5 Y-connectors with hemostatic valves
- 30.6 Microcatheters
- 30.7 Guidewires
- 30.8 Embolic protection devices
- 30.9 Balloons
- 30.10 Atherectomy
- 30.11 Laser
- 30.12 Thrombectomy devices
- 30.13 Aorto-ostial lesion equipment
- 30.14 Stents
- 30.15 Vascular closure devices
- 30.16 CTO PCI dissection/re-entry equipment
- 30.17 Intravascular imaging
- 30.18 Complication management
- 30.19 Radiation protection
- 30.20 Hemodynamic support devices
- 30.21 Contrast management
- 30.22 Brachytherapy
- 30.23 The “CTO—CHIP cart”
- References
- Part E: How to develop a CTO PCI program
- Chapter 31. How to build a successful chronic total occlusion program
- Abstract
- 31.1 Operator
- 31.2 Team
- 31.3 Administration
- 31.4 Referring physicians and patients: increasing awareness of your CTO program
- 31.5 Why CTO PCI will make you a better interventionalist? (this section is reproduced with permission from the CTO Corner of Cardiology Today Interventions)
- References
- Part F: Appendices
- Appendix 1
- Appendix 2
- Index
- Edition: 3
- Published: February 7, 2023
- No. of pages (Paperback): 872
- No. of pages (eBook): 872
- Imprint: Academic Press
- Language: English
- Paperback ISBN: 9780323917872
- eBook ISBN: 9780323918046
EB
Emmanouil Brilakis
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 the Center for. 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 and on the Board of Directors of the Cardiovascular Innovations Foundation. He has authored or co-authored over 600 manuscripts and the Manual of CTO Interventions, now in its 2nd edition. He and is lecturing and proctoring at several institutions in the United States and abroad.
Affiliations and expertise
Director, Center for Complex Coronary Interventions, Minneapolis Heart Institute, Minneapolis, Minnesota; Chairman, Center for Coronary Artery Disease, Minneapolis, MN, USARead Manual of Chronic Total Occlusion Percutaneous Coronary Interventions on ScienceDirect