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Application of penetration device (Tornus) for percutaneous coronary intervention in balloon uncrossable chronic total occlusion-procedure outcomes, complications, and predictors of device success
Objective: To evaluate procedure outcomes, complications, and the predictors of device success while using the Tornus in CTO revascularization. Background: The success of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) may be limited by the presence of severe calcified CTO...
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| Published in: | Catheterization and cardiovascular interventions 2011-09, Vol.78 (3), p.356-362 |
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| container_title | Catheterization and cardiovascular interventions |
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| creator | Fang, Hsiu-Yu Lee, Chien-Ho Fang, Chih-Yuan Lin, Cheng-Jui Wu, Cheng-Ching Yang, Cheng-Hsu Chen, Chien-Jen Hsieh, Yuan-Kai Yip, Hon-Kan Wu, Chiung-Jen |
| description | Objective: To evaluate procedure outcomes, complications, and the predictors of device success while using the Tornus in CTO revascularization. Background: The success of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) may be limited by the presence of severe calcified CTO lesions, especially in the smallest balloon uncrossable arteries. A penetrating device (Tornus) could improve the success rate. Methods: Device and angiographic success rates as well as procedural complications were assessed in 56 patients, who were consecutively and retrospectively enrolled into this study. Device success was defined as successful passage of the Tornus catheter through a CTO lesion. Procedure success was defined by a final TIMI 3 flow and |
| doi_str_mv | 10.1002/ccd.22862 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_896831616</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>896831616</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4282-496f6edfff3b4fd4a2f45c138d7d636271349bd75e2be01b8286a18dc08ff6113</originalsourceid><addsrcrecordid>eNp1kd1u1DAQhSMEoqVwwQsg30El0sZ21kkuqwUWpBUgKD93lmOPhcGxU_8U-n48GO5mu3dceUb-5ujMnKp6ipsz3DTkXEp1RkjPyL3qGK8IqTvCvt_f13ho2VH1KMafTdMMjAwPqyOCW0wxHo6rvxfzbI0UyXiHvEYzOEhhaRVcGwnoxaUPLsdTpH0o_0HmJBz4HJH0wTsRbpBxCcI1uN2YcWgU1vpSZieDj1GMFpD8UWAjUfJJWOSltDkWvJ6Dl6ByAORzkn6C-LIITwdXpRVOoTmAMjL5EG9t7q3FLCXE-Lh6oIWN8GT_nlRf3ry-XL-ttx8279YX21q2pCd1OzDNQGmt6dhq1Qqi25XEtFedYpSRDtN2GFW3AjJCg8e-nFTgXsmm15phTE-q54tu8XyVISY-mSjB2uUevB9YTzHDrJCnC7nbP4DmczBTORXHDb_NjJfM-C6zwj7bq-ZxAnUg70IqwPkC_DYWbv6vxNfrV3eS9TJhYoI_hwkRfnHW0W7Fv73fcPLxE8Xbz1_5hv4Dhca2LA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>896831616</pqid></control><display><type>article</type><title>Application of penetration device (Tornus) for percutaneous coronary intervention in balloon uncrossable chronic total occlusion-procedure outcomes, complications, and predictors of device success</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>Fang, Hsiu-Yu ; Lee, Chien-Ho ; Fang, Chih-Yuan ; Lin, Cheng-Jui ; Wu, Cheng-Ching ; Yang, Cheng-Hsu ; Chen, Chien-Jen ; Hsieh, Yuan-Kai ; Yip, Hon-Kan ; Wu, Chiung-Jen</creator><creatorcontrib>Fang, Hsiu-Yu ; Lee, Chien-Ho ; Fang, Chih-Yuan ; Lin, Cheng-Jui ; Wu, Cheng-Ching ; Yang, Cheng-Hsu ; Chen, Chien-Jen ; Hsieh, Yuan-Kai ; Yip, Hon-Kan ; Wu, Chiung-Jen</creatorcontrib><description>Objective: To evaluate procedure outcomes, complications, and the predictors of device success while using the Tornus in CTO revascularization. Background: The success of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) may be limited by the presence of severe calcified CTO lesions, especially in the smallest balloon uncrossable arteries. A penetrating device (Tornus) could improve the success rate. Methods: Device and angiographic success rates as well as procedural complications were assessed in 56 patients, who were consecutively and retrospectively enrolled into this study. Device success was defined as successful passage of the Tornus catheter through a CTO lesion. Procedure success was defined by a final TIMI 3 flow and <30% residual stenosis. Results: The device success rate was 71.4% in 40 patients and failure rate was 28.6% in 16 patients. The final procedure success was significantly higher in the Tornus success group compared with the Tornus failure group (87.5% vs. 37.5%, P < 0.001). One patient in the Tornus success group (1.8%) had wire perforation resulting in cardiac tamponade and cardiac death. Another patient (1.8%) in the Tornus success group had acute in‐stent thrombosis and non‐Q MI in 24 hr and was resuscitated by emergent PCI. The only independent predictor of device success was a calcium score < 2 (odds ratio (OR): 3.86 (95% CI: 1.14–13.1, P = 0.03). Conclusion: The Tornus catheter can be used in severe calcified CTO PCI when the calcium score <2 and not be used in patients with a calcium score ≥2. © 2011 Wiley‐Liss, Inc.</description><identifier>ISSN: 1522-1946</identifier><identifier>EISSN: 1522-726X</identifier><identifier>DOI: 10.1002/ccd.22862</identifier><identifier>PMID: 21413119</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Aged ; Angioplasty, Balloon, Coronary - adverse effects ; Angioplasty, Balloon, Coronary - instrumentation ; Angioplasty, Balloon, Coronary - mortality ; Catheters ; Chi-Square Distribution ; China ; Chronic Disease ; chronic total occlusion ; Coronary Angiography ; Coronary Occlusion - diagnostic imaging ; Coronary Occlusion - mortality ; Coronary Occlusion - therapy ; Equipment Design ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Patient Selection ; percutaneous coronary intervention ; Predictive Value of Tests ; Retrospective Studies ; Risk Assessment ; Risk Factors ; severe calcified coronary artery ; Severity of Illness Index ; Stents ; Time Factors ; Tornus catheter ; Treatment Outcome ; Vascular Calcification - diagnostic imaging ; Vascular Calcification - mortality ; Vascular Calcification - therapy</subject><ispartof>Catheterization and cardiovascular interventions, 2011-09, Vol.78 (3), p.356-362</ispartof><rights>Copyright © 2011 Wiley‐Liss, Inc.</rights><rights>Copyright © 2011 Wiley-Liss, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4282-496f6edfff3b4fd4a2f45c138d7d636271349bd75e2be01b8286a18dc08ff6113</citedby><cites>FETCH-LOGICAL-c4282-496f6edfff3b4fd4a2f45c138d7d636271349bd75e2be01b8286a18dc08ff6113</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21413119$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fang, Hsiu-Yu</creatorcontrib><creatorcontrib>Lee, Chien-Ho</creatorcontrib><creatorcontrib>Fang, Chih-Yuan</creatorcontrib><creatorcontrib>Lin, Cheng-Jui</creatorcontrib><creatorcontrib>Wu, Cheng-Ching</creatorcontrib><creatorcontrib>Yang, Cheng-Hsu</creatorcontrib><creatorcontrib>Chen, Chien-Jen</creatorcontrib><creatorcontrib>Hsieh, Yuan-Kai</creatorcontrib><creatorcontrib>Yip, Hon-Kan</creatorcontrib><creatorcontrib>Wu, Chiung-Jen</creatorcontrib><title>Application of penetration device (Tornus) for percutaneous coronary intervention in balloon uncrossable chronic total occlusion-procedure outcomes, complications, and predictors of device success</title><title>Catheterization and cardiovascular interventions</title><addtitle>Cathet. Cardiovasc. Intervent</addtitle><description>Objective: To evaluate procedure outcomes, complications, and the predictors of device success while using the Tornus in CTO revascularization. Background: The success of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) may be limited by the presence of severe calcified CTO lesions, especially in the smallest balloon uncrossable arteries. A penetrating device (Tornus) could improve the success rate. Methods: Device and angiographic success rates as well as procedural complications were assessed in 56 patients, who were consecutively and retrospectively enrolled into this study. Device success was defined as successful passage of the Tornus catheter through a CTO lesion. Procedure success was defined by a final TIMI 3 flow and <30% residual stenosis. Results: The device success rate was 71.4% in 40 patients and failure rate was 28.6% in 16 patients. The final procedure success was significantly higher in the Tornus success group compared with the Tornus failure group (87.5% vs. 37.5%, P < 0.001). One patient in the Tornus success group (1.8%) had wire perforation resulting in cardiac tamponade and cardiac death. Another patient (1.8%) in the Tornus success group had acute in‐stent thrombosis and non‐Q MI in 24 hr and was resuscitated by emergent PCI. The only independent predictor of device success was a calcium score < 2 (odds ratio (OR): 3.86 (95% CI: 1.14–13.1, P = 0.03). Conclusion: The Tornus catheter can be used in severe calcified CTO PCI when the calcium score <2 and not be used in patients with a calcium score ≥2. © 2011 Wiley‐Liss, Inc.</description><subject>Aged</subject><subject>Angioplasty, Balloon, Coronary - adverse effects</subject><subject>Angioplasty, Balloon, Coronary - instrumentation</subject><subject>Angioplasty, Balloon, Coronary - mortality</subject><subject>Catheters</subject><subject>Chi-Square Distribution</subject><subject>China</subject><subject>Chronic Disease</subject><subject>chronic total occlusion</subject><subject>Coronary Angiography</subject><subject>Coronary Occlusion - diagnostic imaging</subject><subject>Coronary Occlusion - mortality</subject><subject>Coronary Occlusion - therapy</subject><subject>Equipment Design</subject><subject>Female</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Odds Ratio</subject><subject>Patient Selection</subject><subject>percutaneous coronary intervention</subject><subject>Predictive Value of Tests</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>severe calcified coronary artery</subject><subject>Severity of Illness Index</subject><subject>Stents</subject><subject>Time Factors</subject><subject>Tornus catheter</subject><subject>Treatment Outcome</subject><subject>Vascular Calcification - diagnostic imaging</subject><subject>Vascular Calcification - mortality</subject><subject>Vascular Calcification - therapy</subject><issn>1522-1946</issn><issn>1522-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNp1kd1u1DAQhSMEoqVwwQsg30El0sZ21kkuqwUWpBUgKD93lmOPhcGxU_8U-n48GO5mu3dceUb-5ujMnKp6ipsz3DTkXEp1RkjPyL3qGK8IqTvCvt_f13ho2VH1KMafTdMMjAwPqyOCW0wxHo6rvxfzbI0UyXiHvEYzOEhhaRVcGwnoxaUPLsdTpH0o_0HmJBz4HJH0wTsRbpBxCcI1uN2YcWgU1vpSZieDj1GMFpD8UWAjUfJJWOSltDkWvJ6Dl6ByAORzkn6C-LIITwdXpRVOoTmAMjL5EG9t7q3FLCXE-Lh6oIWN8GT_nlRf3ry-XL-ttx8279YX21q2pCd1OzDNQGmt6dhq1Qqi25XEtFedYpSRDtN2GFW3AjJCg8e-nFTgXsmm15phTE-q54tu8XyVISY-mSjB2uUevB9YTzHDrJCnC7nbP4DmczBTORXHDb_NjJfM-C6zwj7bq-ZxAnUg70IqwPkC_DYWbv6vxNfrV3eS9TJhYoI_hwkRfnHW0W7Fv73fcPLxE8Xbz1_5hv4Dhca2LA</recordid><startdate>20110901</startdate><enddate>20110901</enddate><creator>Fang, Hsiu-Yu</creator><creator>Lee, Chien-Ho</creator><creator>Fang, Chih-Yuan</creator><creator>Lin, Cheng-Jui</creator><creator>Wu, Cheng-Ching</creator><creator>Yang, Cheng-Hsu</creator><creator>Chen, Chien-Jen</creator><creator>Hsieh, Yuan-Kai</creator><creator>Yip, Hon-Kan</creator><creator>Wu, Chiung-Jen</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110901</creationdate><title>Application of penetration device (Tornus) for percutaneous coronary intervention in balloon uncrossable chronic total occlusion-procedure outcomes, complications, and predictors of device success</title><author>Fang, Hsiu-Yu ; Lee, Chien-Ho ; Fang, Chih-Yuan ; Lin, Cheng-Jui ; Wu, Cheng-Ching ; Yang, Cheng-Hsu ; Chen, Chien-Jen ; Hsieh, Yuan-Kai ; Yip, Hon-Kan ; Wu, Chiung-Jen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4282-496f6edfff3b4fd4a2f45c138d7d636271349bd75e2be01b8286a18dc08ff6113</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Angioplasty, Balloon, Coronary - adverse effects</topic><topic>Angioplasty, Balloon, Coronary - instrumentation</topic><topic>Angioplasty, Balloon, Coronary - mortality</topic><topic>Catheters</topic><topic>Chi-Square Distribution</topic><topic>China</topic><topic>Chronic Disease</topic><topic>chronic total occlusion</topic><topic>Coronary Angiography</topic><topic>Coronary Occlusion - diagnostic imaging</topic><topic>Coronary Occlusion - mortality</topic><topic>Coronary Occlusion - therapy</topic><topic>Equipment Design</topic><topic>Female</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Odds Ratio</topic><topic>Patient Selection</topic><topic>percutaneous coronary intervention</topic><topic>Predictive Value of Tests</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>severe calcified coronary artery</topic><topic>Severity of Illness Index</topic><topic>Stents</topic><topic>Time Factors</topic><topic>Tornus catheter</topic><topic>Treatment Outcome</topic><topic>Vascular Calcification - diagnostic imaging</topic><topic>Vascular Calcification - mortality</topic><topic>Vascular Calcification - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fang, Hsiu-Yu</creatorcontrib><creatorcontrib>Lee, Chien-Ho</creatorcontrib><creatorcontrib>Fang, Chih-Yuan</creatorcontrib><creatorcontrib>Lin, Cheng-Jui</creatorcontrib><creatorcontrib>Wu, Cheng-Ching</creatorcontrib><creatorcontrib>Yang, Cheng-Hsu</creatorcontrib><creatorcontrib>Chen, Chien-Jen</creatorcontrib><creatorcontrib>Hsieh, Yuan-Kai</creatorcontrib><creatorcontrib>Yip, Hon-Kan</creatorcontrib><creatorcontrib>Wu, Chiung-Jen</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Catheterization and cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fang, Hsiu-Yu</au><au>Lee, Chien-Ho</au><au>Fang, Chih-Yuan</au><au>Lin, Cheng-Jui</au><au>Wu, Cheng-Ching</au><au>Yang, Cheng-Hsu</au><au>Chen, Chien-Jen</au><au>Hsieh, Yuan-Kai</au><au>Yip, Hon-Kan</au><au>Wu, Chiung-Jen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Application of penetration device (Tornus) for percutaneous coronary intervention in balloon uncrossable chronic total occlusion-procedure outcomes, complications, and predictors of device success</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Cathet. Cardiovasc. Intervent</addtitle><date>2011-09-01</date><risdate>2011</risdate><volume>78</volume><issue>3</issue><spage>356</spage><epage>362</epage><pages>356-362</pages><issn>1522-1946</issn><eissn>1522-726X</eissn><abstract>Objective: To evaluate procedure outcomes, complications, and the predictors of device success while using the Tornus in CTO revascularization. Background: The success of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) may be limited by the presence of severe calcified CTO lesions, especially in the smallest balloon uncrossable arteries. A penetrating device (Tornus) could improve the success rate. Methods: Device and angiographic success rates as well as procedural complications were assessed in 56 patients, who were consecutively and retrospectively enrolled into this study. Device success was defined as successful passage of the Tornus catheter through a CTO lesion. Procedure success was defined by a final TIMI 3 flow and <30% residual stenosis. Results: The device success rate was 71.4% in 40 patients and failure rate was 28.6% in 16 patients. The final procedure success was significantly higher in the Tornus success group compared with the Tornus failure group (87.5% vs. 37.5%, P < 0.001). One patient in the Tornus success group (1.8%) had wire perforation resulting in cardiac tamponade and cardiac death. Another patient (1.8%) in the Tornus success group had acute in‐stent thrombosis and non‐Q MI in 24 hr and was resuscitated by emergent PCI. The only independent predictor of device success was a calcium score < 2 (odds ratio (OR): 3.86 (95% CI: 1.14–13.1, P = 0.03). Conclusion: The Tornus catheter can be used in severe calcified CTO PCI when the calcium score <2 and not be used in patients with a calcium score ≥2. © 2011 Wiley‐Liss, Inc.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>21413119</pmid><doi>10.1002/ccd.22862</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Angioplasty, Balloon, Coronary - adverse effects Angioplasty, Balloon, Coronary - instrumentation Angioplasty, Balloon, Coronary - mortality Catheters Chi-Square Distribution China Chronic Disease chronic total occlusion Coronary Angiography Coronary Occlusion - diagnostic imaging Coronary Occlusion - mortality Coronary Occlusion - therapy Equipment Design Female Humans Logistic Models Male Middle Aged Odds Ratio Patient Selection percutaneous coronary intervention Predictive Value of Tests Retrospective Studies Risk Assessment Risk Factors severe calcified coronary artery Severity of Illness Index Stents Time Factors Tornus catheter Treatment Outcome Vascular Calcification - diagnostic imaging Vascular Calcification - mortality Vascular Calcification - therapy |
| title | Application of penetration device (Tornus) for percutaneous coronary intervention in balloon uncrossable chronic total occlusion-procedure outcomes, complications, and predictors of device success |
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