Treatment of in-stent chronic total occlusions with blunt microdissection.
Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) can be a technical challenge with an average success rate much lower than other lesion types. In-stent restenosis CTOs have inherent features that may be favorable for using the blunt microdissection catheter and may help to improve procedural success. Two successful PCI cases of in-stent restenosis CTO using the blunt microdissection device are presented here. The respective lengths and durations of occlusions are: 40 mm and 1 year, 110 mm and 3 months. Both cases failed initial crossing attempts with conventional and specialized coronary guidewires. Only one other reported case study focused on native coronary in-stent restenosis CTO and the use of the blunt microdissection catheter. This current study presents the use of the blunt microdissection technique in both native coronary and bypass graft in-stent restenosis CTOs. This report adds to the overall experience with this promising approach to a subpopulation of CTO patients with in-stent restenosis.
Ho
Paul C
PC
Division of Cardiology, Hawaii Kaiser Health Plan, Kaiser Foundation Hospital, Honolulu, Hawaii, USA.
D000368:Aged; D002404:Catheterization; D017023:Coronary Angiography; D003327:Coronary Disease / Q000601:surgery*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D042282:Microdissection / Q000295:instrumentation* / Q000379:methods; D008875:Middle Aged; D015607:Stents