Global Chronic Total Occlusion Crossing Algorithm Academic Article uri icon

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abstract

  • The authors developed a global chronic total occlusion crossing algorithm following 10 steps: 1) dual angiography; 2) careful angiographic review focusing on proximal cap morphology, occlusion segment, distal vessel quality, and collateral circulation; 3) approaching proximal cap ambiguity using intravascular ultrasound, retrograde, and move-the-cap techniques; 4) approaching poor distal vessel quality using the retrograde approach and bifurcation at the distal cap by use of a dual-lumen catheter and intravascular ultrasound; 5) feasibility of retrograde crossing through grafts and septal and epicardial collateral vessels; 6) antegrade wiring strategies; 7) retrograde approach; 8) changing strategy when failing to achieve progress; 9) considering performing an investment procedure if crossing attempts fail; and 10) stopping when reaching high radiation or contrast dose or in case of long procedural time, occurrence of a serious complication, operator and patient fatigue, or lack of expertise or equipment. This algorithm can improve outcomes and expand discussion, research, and collaboration.

authors

  • Wu, Eugene B
  • Brilakis, Emmanouil S
  • Mashayekhi, Kambis
  • Tsuchikane, Etsuo
  • Alaswad, Khaldoon
  • Araya, Mario
  • Avran, Alexandre
  • Azzalini, Lorenzo
  • Babunashvili, Avtandil M
  • Bayani, Baktash
  • Behnes, Michael
  • Bhindi, Ravinay
  • Boudou, Nicolas
  • Boukhris, Marouane
  • Bozinovic, Nenad Z
  • Bryniarski, Leszek
  • Bufe, Alexander
  • Buller, Christopher E
  • Burke, M Nicholas
  • Buttner, Achim
  • Cardoso, Pedro
  • Carlino, Mauro
  • Chen, Ji-Yan
  • Christiansen, Evald Hoej
  • Colombo, Antonio
  • Croce, Kevin
  • de los Santos, Felix Damas
  • de Martini, Tony
  • Dens, Joseph
  • di Mario, Carlo
  • Dou, Kefei
  • Egred, Mohaned
  • Elbarouni, Basem
  • ElGuindy, Ahmed M
  • Escaned, Javier
  • Furkalo, Sergey
  • Gagnor, Andrea
  • Galassi, Alfredo R
  • Garbo, Roberto
  • Gasparini, Gabriele
  • Ge, Junbo
  • Ge, Lei
  • Goel, Pravin Kumar
  • Goktekin, Omer
  • Gonzalo, Nieves
  • Grancini, Luca
  • Hall, Allison
  • Hanna Quesada, Franklin Leonardo
  • Hanratty, Colm
  • Harb, Stefan
  • Harding, Scott A
  • Hatem, Raja
  • Henriques, Jose PS
  • Hildick-Smith, David
  • Hill, Jonathan M
  • Hoye, Angela
  • Jaber, Wissam
  • Jaffer, Farouc A
  • Jang, Yangsoo
  • Jussila, Risto
  • Kalnins, Artis
  • Kalyanasundaram, Arun
  • Kandzari, David E
  • Kao, Hsien-Li
  • Karmpaliotis, Dimitri
  • Kassem, Hussien Heshmat
  • Khatri, Jaikirshan
  • Knaapen, Paul
  • Kornowski, Ran
  • Krestyaninov, Oleg
  • Kumar, AV Ganesh
  • Lamelas, Pablo
  • Lee, Seung-Whan
  • Lefevre, Thierry
  • Leung, Raymond
  • Li, Yu
  • Li, Yue
  • Lim, Soo-Teik
  • Lo, Sidney
  • Lombardi, William
  • Maran, Anbukarasi
  • McEntegart, Margaret
  • Moses, Jeffrey
  • Munawar, Muhammad
  • Navarro, Andres
  • Ngo, Hung M
  • Nicholson, William
  • Oksnes, Anja
  • Olivecrona, Goran K
  • Padilla, Lucio
  • Patel, Mitul
  • Pershad, Ashish
  • Postu, Marin
  • Qian, Jie
  • Quadros, Alexandre
  • Rafeh, Nidal Abi
  • Råmunddal, Truls
  • Prakasa Rao, Vithala Surya
  • Reifart, Nicolaus
  • Riley, Robert F
  • Rinfret, Stephane
  • Saghatelyan, Meruzhan
  • Sianos, George
  • Smith, Elliot
  • Spaedy, Anthony
  • Spratt, James
  • Stone, Gregg
  • Strange, Julian W
  • Tammam, Khalid O
  • Thompson, Craig A
  • Toma, Aurel
  • Tremmel, Jennifer A
  • Trinidad, Ricardo Santiago
  • Ungi, Imre
  • Vo, Minh
  • Vu, Vu Hoang
  • Walsh, Simon
  • Werner, Gerald
  • Wojcik, Jaroslaw
  • Wollmuth, Jason
  • Xu, Bo
  • Yamane, Masahisa
  • Ybarra, Luiz F
  • Yeh, Robert W
  • Zhang, Qi

publication date

  • August 2021