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Complications of Chronic Total Occlusion Percutaneous Coronary Intervention

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Percutaneous Intervention for Coronary Chronic Total Occlusion

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Abstract

Percutaneous coronary intervention of chronic total occlusions has gained attention over the past 10 years. This is due to advances in technology, techniques and the hybrid algorithm. A systematic approach to these complex procedures may reduce the risk of complications. Complications are inevitable but awareness of the etiology and treatment of the complications is imperative. An algorithmic approach to complication management will allow the operator to more skillfully diagnose and manage the situation.

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Author information

Authors and Affiliations

  1. Department of Cardiology, William Beaumont Hospital, Royal Oak, MI, USA

    Rolf Graning MD

  2. Department of Cardiology, Advocate Heart Institute, Downers Grove, IL, USA

    Tony DeMartini MD

Authors
  1. Rolf Graning MD
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  2. Tony DeMartini MD
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Corresponding author

Correspondence to Rolf Graning MD .

Editor information

Editors and Affiliations

  1. Multidisciplinary Cardiology Department, Quebec Heart and Lung Institute, Quebec, Canada

    Stéphane Rinfret

Electronic supplementary material

Video 15.1

Donor artery dissection that manifested a few hours after the CTO PCI: Dual transradial injection using an AL 1 in the RCA and a 7F XB 3.5 in the LAD, both delivered without a sheath. (AVI 3768 kb)

Video 15.2

Donor artery dissection that manifested a few hours after the CTO PCI: Dual transradial injection using an AL 1 in the RCA and a 7F XB 3.5 in the LAD, both delivered without a sheath. (AVI 2512 kb)

Video 15.3

Donor artery dissection that manifested a few hours after the CTO PCI:. Retrograde approach and GuideLiner Reverse CART. (AVI 5464 kb)

Video 15.4

Donor artery dissection that manifested a few hours after the CTO PCI:. Suspicion of a small intimal tear in the mid segment of the left main. (AVI 2267 kb)

Video 15.5

Donor artery dissection that manifested a few hours after the CTO PCI:. IVUS in the distal, mid and proximal segments of the left main that did not reveal any tear or flap. (AVI 60421 kb)

Video 15.6

Donor artery dissection that manifested a few hours after the CTO PCI:. Final RCA result. (AVI 1790 kb)

Video 15.7

Donor artery dissection that manifested a few hours after the CTO PCI:. Final angiography on the left; the suspected image in the left main had disappeared. (AVI 2689 kb)

Video 15.8

Donor artery dissection that manifested a few hours after the CTO PCI:. 3 h later, patient presented sudden chest pain associated with high-blood pressure (180/95), followed by hypotension and sudation. Urgent catheterization revealed a clear dissection of the left main, with reduced flow. (AVI 1718 kb)

Video 15.9

Donor artery dissection that manifested a few hours after the CTO PCI:. Following complex trifurcation stenting of the left main. (AVI 2730 kb)

Video 15.10

Donor artery dissection that manifested a few hours after the CTO PCI:. Control angiography on the right showed patent stents and significant remodelling of the PDA. The patient was sent home 2 days later. In retrospective, a stent should have been placed as soon as a doubt was raised about a potential intimal tear. (AVI 2403 kb)

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© 2016 Springer International Publishing Switzerland

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Graning, R., DeMartini, T. (2016). Complications of Chronic Total Occlusion Percutaneous Coronary Intervention. In: Rinfret, S. (eds) Percutaneous Intervention for Coronary Chronic Total Occlusion. Springer, Cham. https://doi.org/10.1007/978-3-319-21563-1_15

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  • DOI: https://doi.org/10.1007/978-3-319-21563-1_15

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-21562-4

  • Online ISBN: 978-3-319-21563-1

  • eBook Packages: MedicineMedicine (R0)

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