63 research outputs found
TCT-261 One-year outcomes of the hybrid CTO revascularization strategy: a sub-analysis of the multicenter RECHARGE Registr
No full textEvolution des paramètres physiologiques entre le début et la fin de saison chez le footballeur professionnel
No full textPARIS6-Bibl.Pitié-Salpêtrie (751132101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Utility of Intravascular Ultrasound in Percutaneous Revascularization of Chronic Total Occlusions
No full textIntravascular ultrasound has been used for >20 years to guide percutaneous coronary intervention in different subsets of
coronary lesions. During the last decade, the interest in percutaneous coronary intervention for chronic total occlusion
(CTO) has increased dramatically, leading to high success rates. Failure of guidewire crossing is the most common reason for
failed CTO attempts. Certain angiographic features, such as blunt proximal CTO cap, tortuosity, heavy calcification, and lack
of visibility of path in the distal vessel, increase procedural difficulty. A better understanding of the behavior of the
guidewire within the CTO segment may represent a key issue to achieve successful outcome. In this respect, intravascular
ultrasound imaging might have potential roles in the recanalization of CTOs. In this paper, we focused on the usefulness
and the applications of intravascular ultrasound imaging in percutaneous CTO recanalization, underlying its impact on
clinical outcome. (J Am Coll Cardiol Intv 2016;9:1979–91) © 2016 by the American College of Cardiology Foundatio
Antegrade Dissection and Reentry as Part of the Hybrid Chronic Total Occlusion Revascularization Strategy: A Subanalysis of the RECHARGE Registry (Registry of CrossBoss and Hybrid Procedures in France, the Netherlands, Belgium and United Kingdom)
No full textBackground - Development of the CrossBoss and Stingray devices for antegrade dissection and reentry (ADR) of chronic total occlusions has improved historically suboptimal outcomes. However, the outcomes, safety, and failure modes of the technique have to be studied in a larger patient cohort. This preplanned substudy of the RECHARGE registry (Registry of CrossBoss and Hybrid Procedures in France, the Netherlands, Belgium and United Kingdom) aims to evaluate the value and use of ADR and determine its future position in contemporary chronic total occlusion intervention. Methods and Results - Patients were selected if an ADR strategy was applied. Outcomes, safety, and failure modes of the technique were assessed. The ADR technique was used in 23% (n=292/1253) of the RECHARGE registry and was mainly applied for complex lesions (Japanese chronic total occlusion score=2.7±1.1). ADR was the primary strategy in 30% (n=88/292), of which 67% were successful. Bail-out ADR strategies were successful in 63% (n=133/210). The Controlled ADR (ie, combined CrossBoss-Stingray) subtype was applied most frequently (32%; n=93/292) and successfully (81%; n=75/93). Overall per-lesion success rate was 78% (n=229/292), after use of additional bail-out strategies. The inability to reach the distal target zone (n=48/100) or to reenter (n=43/100) most commonly led to failure. ADR-associated major events occurred in 3.4% (n=10/292). Conclusions - Although mostly applied as a bail-out strategy for complex lesions, the frequency, outcomes, and low complication rate of the ADR technique and its subtypes confirm the benefit and value of the technique in hybrid chronic total occlusion percutaneous coronary intervention, especially when antegrade wiring or retrograde approaches are not feasible
Gender differences in percutaneous coronary intervention for chronic total occlusions from the ERCTO study
No full textAn algorithmic approach for the management of ostial right coronary artery chronic total occlusions
No full textPost-stEnting assessment of Reendothelialization with optical Frequency domain imaging aftEr Chronic Total Occlusion procedure: the PERFE-CTO study design and rationale
No full textInternational audienceThe treatment of chronic total occlusion of coronary arteries by percutaneous coronary intervention (CTO PCI) is one of the most representative technical advances in ischemic cardiomyopathy of last decade. However, how the complex histopathological remodeling and the new techniques affect healing processes after stent implantation remains unknown
Percutaneous recanalisation of chronic total occlusions: 2019 consensus document from the EuroCTO Club
No full textSince its inception in December 2006, the EuroCTO Club has strived to provide the framework for state-of-the-art chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in Europe and nearby regions. Among its initiatives, the EuroCTO Club has published a set of recommendations regarding the technical aspects of CTO PCI, whose last edition dates to 2012. The EuroCTO Club consensus document discusses CTO PCI clinical indications, techniques and equipment use, as well as the qualifications of operators/centres. Given the considerable amount of progress made by this subspecialty in recent years, there is a need for an updated document that includes data from recent clinical trials and registries, information on novel devices and techniques, and an up-to-date revision on the training requirements to approach CTO PCI. The current updated consensus document of the EuroCTO Club reflects the expertise of European operators to promote the widespread application of state-of-the-art CTO PCI, not only in Europe but also across neighbouring communities
Discharge of newborns with risk factors of severe hyperbilirubinemia: description of a hospital at home-based care monitoring and phototherapy
No full textInternational audienceNeonatal jaundice is common and associated with delay in hospital discharge and risk of neurological sequelae if not treated. The objectives of the study were to report on our experience of the monitoring and treatment of neonatal jaundice in a home care setting and its feasibility and safety for neonates with high risk of severe hyperbilirubinemia. The 2-year study has been led in the greater Paris University Hospital At Home (Assistance Publique—Hôpitaux de Paris). The device of the intervention was the Bilicocoon® Bag, a light-emitting diode sleeping bag worn by the neonate when the total serum bilirubin value exceeds intensive phototherapy threshold, according to the guidelines from the American Academy of Pediatrics. One hundred and thirty-nine neonates had participated in the intervention and 39 (28%) were treated by phototherapy at home, as continuation of inpatient phototherapy or started at home. Seventy-five percent of the sample had more than two risk factors for development of severe hyperbilirubinemia. Twenty five percent of the cohort who received phototherapy at home had lower gestational age (p < 0.014) and had younger age at discharge from maternity (p < 0.09). Median length of stay in hospital at home was 5 days. Two patients needed readmission in conventional hospital (1%) for less than 24 h. In multivariate model, the length of stay decreased with the higher gestational age (p < 0.001) and increased significantly with the older age at discharge, the birth weight < 10th percentile, and a treatment by phototherapy at home. Conclusion: Hospital at home, which is a whole strategy using an effective and convenient phototherapy device combined with a specialized medical follow-up, could be an alternative to conventional hospitalization for neonates at high risk of severe jaundice. The maternity discharge is facilitated, the mother-infant bonding can be promoted, and the risk of conventional rehospitalization is minimal, while guaranteeing the safety of this specific care.What is Known:•Managing neonatal jaundice is provided in conventional hospital with phototherapy.• Neonatal jaundice increases the risk of prolonged hospitalization or readmission.What is New:•Phototherapy is feasible in hospital at home for neonates with high risk of severe hyperbilirubinemia.• The care pathway of neonates from conventional hospital to hospital at home is described
The hybrid toolkit for Chronic total occlusions: materials used in the RECHARGE Registry (REgistry of Crossboss and Hybrid procedures in FrAnce, the NetheRlands, BelGium and UnitEd Kingdom)
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