Wir setzen Cookies ein und sammeln Informationen von Ihrem Browser, um Ihre Anforderungen besser zu verstehen und Ihnen relevante Inhalte zur Verfügung zu stellen. 2011;4:213-21. Understanding the histopathological distribution of calcium may have an important impact on guiding percutaneous treatment of heavily calcified CTOs. Wir helfen Ihnen bei Ihren Anliegen gerne persönlich weiter. 2019;140:420-33. Inhaltsverzeichnis 1 Geschichte 2 Struktur (Einrichtungen, Abteilungen, Leistungsdaten) Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases Ghoshhajra BB, Takx RAP, Stone LL, Girard EE, Brilakis ES, Lombardi WL, Yeh RW, Jaffer FA. Catheter Cardiovasc Interv. EuroIntervention. Bei aktiviertem Cookie wird z.B. 12. Effect of Coronary CTA on Chronic Total Occlusion Percutaneous Coronary Intervention: A Randomized Trial. Grades [I44.2], Datengrundlage sind Qualitätsberichte der Krankenhäuser gemäß § 137 Abs. After wire crossing, characterisation of the lesion anatomy with intravascular imaging can further offer invaluable insights to guide tool selection for a tailored lesion preparation5. Crossing of a heavily calcified RCA CTO. Intravascular lithotripsy in chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS-CTO registry. In particular, heavy calcification (HC) may preclude wire advancement within the intraplaque space of the occlusion, forcing the operator to use extraplaque techniques that are associated with higher periprocedural risk and a potentially poorer outcome12. Cardiologia, Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza (ProMISE) “G. Dr. med. Mattesini A, Nardi G, Martellini A, Sorini Dini C, Hamiti B, Stolcova M, Meucci F, Di Mario C. Intravascular Imaging to Guide Lithotripsy in Concentric and Eccentric Calcific Coronary Lesions. 27. 2. Epub 2023 Feb 9. 2017;10:e005800. Accordingly, it was made part of the Korean Multicenter CTO CT Registry (KCCT) score24. B) Lesion preparation: balloon dilatation using non-compliant (NC) balloons (balloon dimension/vessel reference 1:1) should be performed to adequately prepare the lesion for stent implantation, by confirming the full expansion of the balloon in two angiographic views; IVUS should be performed before drug-eluting stent (DES) implantation. Maurer BJ, Oberman A, Holt JH Jr, Kouchoukos NT, Jones WB, Russell RO Jr, Reeves TJ. In this case, calcification did not emerge as a predictor of procedural failure, probably due to the liberal and early use of extraplaque dissection techniques that potentially “bypassed” intimal calcification. Disclaimer. Department of Cardiology, Heart Centre Niederrhein, Helios Clinics Krefeld, Krefeld, Germany; 13. In Anerkennung seines Engagements, seiner wissenschaftlichen Arbeit und außerordentlichen klinischen Tätigkeit, hat die Universität Witten / Herdecke den gebürtigen Westfalen nun zum außerplanmäßigen Professor ernannt. A,B) The coronary angiography (dual injection) of a highly symptomatic post-CABG patient with a CTO of the proximal/mid-LAD (dotted white line) and a still functioning LIMA graft (showed with “#”), insufficiently supplying the mid-distal LAD through a diffusely stenotic segment of the native diagonal branch. Development and Validation of a Novel Scoring System for Predicting Technical Success of Chronic Total Occlusion Percutaneous Coronary Interventions: The PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) Score. Dient zur Unterscheidung einzelner Nutzer. The Hybrid Approach to Chronic Total Occlusion Percutaneous Coronary Intervention: Update From the PROGRESS CTO Registry. The use of ADR for heavily calcified CTOs is facilitated by a large distal vessel without significant calcification, in order to be able to re-enter the vessel lumen by puncturing through the calcified vascular layers37. Treffer 1 - 13 von 174 1 Treffer im Telefonverzeichnis. Von Chrismie Fehrmann Krefeld. 2. In a retrospective cohort of 285 patients undergoing CCTA before CTO PCI, Ito et al showed that CTO PCI in patients with severe calcification resulted in higher rates of in-stent restenosis and target lesion failure7. 16. Das Helios Klinikum Krefeld, das Helios St. Josefshospital Uerdingen und das Helios Cäcilien-Hospital Hüls firmieren seit Januar 2023 als ein Klinikum unter dem Dach der Helios Klinikum Krefeld GmbH.... Mit Helios finden Sie für jedes gesundheitliche Anliegen das richtige Angebot. 3 Satz 1 Nr. Eine vollständige unveränderte Darstellung der Qualitätsberichte der Krankenhäuser erhalten Sie unter https://www.g-ba.de. Unsere Kernkompetenz ist der Blick durchs Schlüsselloch. Overall, severe calcification is more common in native CTOs compared to in-stent (IS) CTOs. Mit dem Da Vinci Xi-Operationssystem steht uns die derzeit modernste Technik für minimal-invasive Eingriffe zur Verfügung. ADR: antegrade dissection re-entry; AWE: antegrade wire escalation; CTO: chronic total occlusion; IVL: intravascular lithotripsy; IVUS: intravascular ultrasound; MC: microcatheter; MSCT: multislice computed tomography; RDR: retrograde dissection re-entry; RWE: retrograde wire escalation. Wenn es nicht mehr kann, wie es soll, unterstützen wir mit allen Möglichkeiten der modernen Herzmedizin – individuell und persönlich. Fujino A, Otsuji S, Hasegawa K, Arita T, Takiuchi S, Fujii K, Yabuki M, Ibuki M, Nagayama S, Ishibuchi K, Kashiyama T, Ishii R, Tamaru H, Yamamoto W, Hara M, Higashino Y. Structural Interventional Cardiology, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy; 21. U.O.C. Accordingly, calcific tissue can be quantified and localised. Kobayashi Y, Okura H, Kume T, Yamada R, Kobayashi Y, Fukuhara K, Koyama T, Nezuo S, Neishi Y, Hayashida A, Kawamoto T, Yoshida K. Impact of target lesion coronary calcification on stent expansion. C) The three-dimensional computed tomographic reconstruction of the native coronary arteries (occluded LAD indicated with the asterisk), as well as the grafts. CTO: chronic total occlusion. Epub 2023 Apr 7. Srivatsa et al showed that the content of calcium increases with advancing age of the CTO11. Der Chefarzt der Kardiologie wird von der Universität Witten/Herdecke zum außerplanmäßigen Professor ernannt. 47805 Krefeld - https://www.helios-gesundheit.de. Facharzt für Innere Medizin und Kardiologie Schwerpunkte: Interventionelle Klappentherapie, Rekanalisation chronischer Koronarverschlüsse (CTO) Fachbereiche Kardiologie Kurzvita Ausbildung Berufsweg Bei Helios Qualifikationen Weitere Funktionen Lehrtätigkeiten Universität Witten/Herdecke Publikationen Einsehbar unter pubmed Nachrichten 6. Circ J. Intraplaque CTO tracking is almost always associated with high friction due to the advancement of equipment through the calcified segment. 5. 2015;8:461-71. Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria "Policlinico-S. Marco", University of Catania, Catania, Italy; 12. - Interventional therapy of acute myocardial infarction, We speak german, english, russian, arabic and french, Specialities (${ items.specialisms.length }), Helios International Office (Mon.-Thurs. 28. Garbo R, Di Russo C, Sciahbasi A, Fedele S. The last resort during complex retrograde percutaneous coronary chronic total occlusion intervention: Extraplaque intracoronary lithotripsy to externally crush a heavy calcified occluded stent. JACC Cardiovasc Interv. J Nucl Med. Seit mehreren Jahren engagiert er sich in seinem Fachbereich akademisch in Forschung und Lehre: In seiner Funktion als Trainer bildet er regelmäßig Kollegen aus aller Welt aus, ist zur Zertifizierung von Zentren berechtigt und Mitglied im Wissenschaftlichen Beirat der Deutschen Herzstiftung.Die minimalinvasiven Kathetertechniken sind seine berufliche Passion, deren weiteren Verfeinerung er sich mit großer Leidenschaft verschrieben hat. Brilakis ES, Grantham JA, Rinfret S, Wyman RM, Burke MN, Karmpaliotis D, Lembo N, Pershad A, Kandzari DE, Buller CE, DeMartini T, Lombardi WL, Thompson CA. Der Dienst von Google Analytics hilft uns dabei, unsere Website zu verbessern, indem Informationen über ihre Nutzung erfasst und analysiert werden. Die Website kann ohne diese Cookies nicht ordnungsgemäß funktionieren. MediClin Heart Center Lahr, Lahr, Germany; 2. Lutherplatz 40 47805 Krefeld Nordrhein-Westfalen Zur Homepage der Klinik 612 von 802 Nutzern würden diese Klinik empfehlen Gesamtzufriedenheit Qualität der Beratung Medizinische Behandlung Verwaltung und Abläufe Ausstattung und Gestaltung Eigene Bewertung abgeben Erfahrungsberichte (813) Anfragen (0) Die Klinik stellt sich vor Statistiken This site needs JavaScript to work properly. Circ Cardiovasc Interv. With global collaboration and knowledge sharing, we have identified 7 common principles that are widely accepted as best practices for CTO-PCI. These principles have been widely adopted by experienced CTO-PCI operators and centers currently achieving high success and acceptable complication rates. Table 1. Safety and Efficiency of Rotational Atherectomy in Chronic Total Coronary Occlusion-One-Year Clinical Outcomes of an Observational Registry. Das Einverständnis in die Verwendung der Cookies können Sie jederzeit widerrufen. You are listening to an article that has been audio-augmented with artificial intelligence technology. Das Einstellungs-Cookie erlaubt, Ihre persönlichen Einstellungen in Ihrem Browser abzuspeichern. ADR: antegrade dissection re-entry; BAM: balloon-assisted microdissection; BASE: balloon-assisted subintimal entry; RDR: retrograde dissection-re-entry. 2018 Jul 23;11(14):1325-1335. doi: 10.1016/j.jcin.2018.02.036. Krankenhaus Helios Klinikum Krefeld. In a study by Fujii et al, intravascular ultrasound (IVUS) identified coronary calcification in 96% of patients with CTOs, while angiography-detected calcification was found in only 61%30. Bufe in Krefeld. Profilbildungen) / zu Zwecken Dritter verarbeiten. Urologische Erkrankungen können jeden treffen: Männer, Frauen und Kinder. OCT may also be valuable for follow-up diagnostic assessments, for the detection of neoatherosclerosis, malapposition, and stent underexpansion31. 2017;90:12-20. A percutaneous treatment algorithm for crossing coronary chronic total occlusions. Klinik Kardiologie Augusta Krankenhaus, Düsseldorf, Germany; 18. eCollection 2023. Seine klinischen und Forschungsschwerpunkte liegen im Bereich der operativen und medikamentösen Behandlung aller gynäkologischen Malignome einschließlich des Mammakarzinoms . Kartenansicht. The value of quantitative plaque analysis based on coronary computed tomography angiography in predicting the percutaneous coronary intervention outcome of chronic total occlusion lesions. If the initially selected crossing strategy fails, efficient change to an alternative crossing technique increases the likelihood of eventual PCI success, shortens procedure time, and lowers radiation and contrast use. 24. 20. Vo MN, Christopoulos G, Karmpaliotis D, Lombardi WL, Grantham JA, Brilakis ES. 13. Services jobs.kliniken.de. Kawakami R, Hao H, Takagi Y, Fujino A, Tsuchida YA, Imanaka T, Fujii K, Hirota S. Drug-Eluting Stent Implantation on Calcified Nodule: Ex Vivo Intravascular Images and Histopathology. (EAPCI), The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI), 1. Following the wire crossing, an initial plaque modification using cutting balloon dilatation was performed in order to allow delivery of the IVUS catheter; B) IVUS assessment showed an ostial calcium nodule (asterisks), responsible for the incomplete stent expansion, that eventually led to vessel occlusion. Fachabteilung, Arzt, Behandlung suchen. Medizinische Klinik I, Klinikum Fürth, Fürth, Germany; 2. Intraplaque tracking (antegrade, retrograde) should be preferred as the initial crossing strategy; in case of failure (i.e., extraplaque tracking of the occluded segment) dissection and re-entry techniques should be used as second-line options. Epub 2016 Mar 14. 37. Dr. med. Erforderliche Felder sind markiert *. Karacsonyi J, Karmpaliotis D, Alaswad K, Jaffer FA, Yeh RW, Patel M, Bahadorani J, Doing A, Ali ZA, Karatasakis A, Danek BA, Rangan BV, Alame AJ, Banerjee S, Brilakis ES. The site is secure. The incidence of major adverse cardiac events was significantly higher in the subset of patients with heavily calcified CTOs (3.7% vs 1.8%; p=0.033). Bufe in Krefeld. doi: 10.1002/ccd.26785. : - Gelenkerhalt von Hüft- und Kniegelenk inklusive Umstellungsoperationen bei präarthrotischen Deformitäten Nutzen Sie unser Netzwerk aus Akutkliniken, ambulanten Praxen, Rehakliniken und –zentren sowie Pflegeeinrichtungen, Privatkliniken und Präventionszentren. Heavy calcification, alongside with proximal vessel tortuosity and lesion length, may prevent PCI equipment from reaching the CTO site. Very high-pressure balloon inflation should be avoided in these cases, as there is a risk of non-focal, large extraplaque vessel perforations. 1996;38:229-35. Wir helfen Ihnen bei Ihren Anliegen gerne persönlich weiter. Figure 1. 2014;78:2209-14. 2021;14:1993-2004. Department of Cardiology and Cardiovascular Interventions, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland; 11. *Including calcific nodules. Karacsonyi et al assessed 1,453 consecutive CTO PCI patients and showed that moderate-to-severe coronary calcium was associated with lower technical and procedural success rates8. 2023 May 17;12(10):3510. doi: 10.3390/jcm12103510. 2011;4:588-9. therefore contain some imperfections and we kindly ask for your patience and understanding. First, the lack of resolution, depending on the CT scanner used, can heavily affect the definition of critical characteristics of a heavily calcified CTO lesion such as the calcium thickness. Khan S, Fawaz S, Simpson R, Robertson C, Kelly P, Mohdnazri S, Tang K, Cook CM, Gallagher S, O'Kane P, Spratt J, Brilakis ES, Karamasis GV, Al-Lamee R, Keeble TR, Davies JR. Front Cardiovasc Med. Alternatively, the balloon-assisted microdissection (BAM) technique can be used to achieve proximal CTO cap disruption: a small (1.25-1.50 mm) balloon is engaged proximally to the CTO and inflated up to its rupture. 2006;97:1455-62. 4. 19. Weitere Informationen zu Cookies auf dieser Website finden Sie in unserer Datenschutzhinweise. +49 2151 3. Catheter Cardiovasc Interv. Keywords: Hasegawa K, Tsuchikane E, Okamura A, Fujita T, Yamane M, Oikawa Y, Suzuki Y, Igarashi Y, Kyo E, Muramatsu T. Incidence and impact on midterm outcome of intimal versus subintimal tracking with both antegrade and retrograde approaches in patients with successful recanalisation of chronic total occlusions: J-PROCTOR 2 study. Die Qualitätsberichte der Krankenhäuser werden vorliegend nur teilweise bzw. 15. A) Dual injection showing a CTO of the proximal RCA, expanding up to the crux. The Official Journal of EuroPCR and the European Associationof Percutaneous Coronary Interventions Mastering antegrade and retrograde dissection-re-entry (RDR) techniques is recommended before embarking on heavily calcified CTO treatment. Prevalence, indications and management of balloon uncrossable chronic total occlusions: Insights from a contemporary multicenter US registry. However, OCT has higher resolution and can be used for stent optimisation after stent deployment, if contrast administration has been limited. Mintz GS. 7. 6. EuroIntervention 2023;19:e113-e122. Uncrossable lesions – stepwise approach and recommendations. Department of Interventional Cardiology, Clinique Pasteur, Essey-lès-nancy, France; 5. Figure 5. Prof. Dr. med. 34. Vo MN, Karmpaliotis D, Brilakis ES. Schließen Menü . Brilakis ES, Mashayekhi K, Tsuchikane E, Abi Rafeh N, Alaswad K, Araya M, Avran A, Azzalini L, Babunashvili AM, Bayani B, Bhindi R, Boudou N, Boukhris M, Bozinovic NZ, Bryniarski L, Bufe A, Buller CE, Burke MN, Buttner HJ, Cardoso P, Carlino M, Christiansen EH, Colombo A, Croce K, Damas de Los Santos F, De Martini T, Dens J, Di Mario C, Dou K, Egred M, ElGuindy AM, Escaned J, Furkalo S, Gagnor A, Galassi AR, Garbo R, Ge J, Goel PK, Goktekin O, Grancini L, Grantham JA, Hanratty C, Harb S, Harding SA, Henriques JPS, Hill JM, Jaffer FA, Jang Y, Jussila R, Kalnins A, Kalyanasundaram A, Kandzari DE, Kao HL, Karmpaliotis D, Kassem HH, Knaapen P, Kornowski R, Krestyaninov O, Kumar AVG, Laanmets P, Lamelas P, Lee SW, Lefevre T, Li Y, Lim ST, Lo S, Lombardi W, McEntegart M, Munawar M, Navarro Lecaro JA, Ngo HM, Nicholson W, Olivecrona GK, Padilla L, Postu M, Quadros A, Quesada FH, Prakasa Rao VS, Reifart N, Saghatelyan M, Santiago R, Sianos G, Smith E, J CS, Stone GW, Strange JW, Tammam K, Ungi I, Vo M, Vu VH, Walsh S, Werner GS, Wollmuth JR, Wu EB, Wyman RM, Xu B, Yamane M, Ybarra LF, Yeh RW, Zhang Q, Rinfret S. Guiding Principles for Chronic Total Occlusion Percutaneous Coronary Intervention. Azzalini L, Dautov R, Ojeda S, Serra A, Benincasa S, Bellini B, Giannini F, Chavarria J, Gheorghe LL, Pan M, Carlino M, Colombo A, Rinfret S. Long-term outcomes of rotational atherectomy for the percutaneous treatment of chronic total occlusions. Das Magazin Focus-Gesundheit hat die Liste mit Hilfe des unabhängigen Recherche-Institus Munich . Rotational, orbital and – where available – laser atherectomy, need to be utilised in these cases before a non-compliant balloon is able to be delivered (Figure 5). Urologische Erkrankungen können jeden treffen: Männer, Frauen und Kinder. Medizinische Klinik I (Cardiology & Intensive Care), Klinikum Darmstadt GmbH, Darmstadt, Germany; 4. Alexander Bufe HELIOS Klinikum Krefeld Medizinische, Klinik I Lutherplatz 40 47805 Krefeld +49 2151 3. Akademisches . The https:// ensures that you are connecting to the Datenschutzhinweise The proximal CTO cap can be also modified using the balloon-assisted subintimal entry (BASE) technique (Figure 4), by creating a dissection in front of the proximal CTO cap and entering the extraplaque space using a polymer-jacketed wire in the form of a knuckle32. Specific microcatheters such as the Tornus (Asahi Intecc) or the Turnpike Gold (Teleflex) have a metallic tip and can be used to penetrate and disrupt the proximal heavily calcified CTO cap. 2017;89:820-8. Brilakis ES, Banerjee S. Dancing with the “STAR”: the role of subintimal dissection/re-entry strategies in coronary chronic total occlusion interventions. The above-mentioned algorithms acknowledge the presence of HC within the CTO segment as an important obstacle to overcome and propose using dissection/re-entry techniques to facilitate CTO crossing. and transmitted securely. Zum internationalen Frauentag erläutert Dr. Brigitte Bathgate, kardiologische Oberärztin am Helios Herzzentrum Niederrhein, welche Risikofaktoren einen Herzinfarkt begünstigen und worauf Frauen... Sie haben Fragen? Zertifiziertes Behandlungszentrum für Patient:innen mit Vorhofflimmern, Überregionales Behandlungszentrum für die Herzschwäche (Heart Failure Unit), Von der Deutschen Gesellschaft für Kardiologie (DGK) zertifizierte Brustschmerz-Ambulanz, Offizieller Partner des Olympiastützpunktes NRW/Rhein-Ruhr, Zusatzqualifikation - von der Deutschen Gesellschaft für Kardiologie (DGK) zertifiziert, Ausbildungsstätte - von der Deutschen Gesellschaft für Kardiologie (DGK) zertifiziert, Schulungszentrum für die Wiedereröffnung chronischer Koronarverschlüsse (CTO). Using intravascular imaging allows differentiation between concentric and eccentric calcium distribution. Eur Radiol. Rainer Ott Leitender Oberarzt der Medizinischen Klinik I Dr. med. Alexander Bufe Chefarzt der Medizinischen Klinik I Priv.-Doz. PMC Fujii K, Ochiai M, Mintz GS, Kan Y, Awano K, Masutani M, Ashida K, Ohyanagi M, Ichikawa S, Ura S, Araki H, Stone GW, Moses JW, Leon MB, Carlier SG. Tel: 02151 32-0. FREE ARTICLE - Amerjeet Singh Banning et al, Early safety and feasibility of a first-in-class biomimetic transcatheter aortic valve (DurAVR), TAVI for bicuspid aortic valves with Evolut platform, Online ISSN 1969-6213 - Print ISSN 1774-024X, Other valvular and structural interventions. This site uses cookies in order to provide you with the best possible service. Epub 2021 Nov 23. Coronary Computed Tomography Angiography Predicts Guidewire Crossing and Success of Percutaneous Intervention for Chronic Total Occlusion: Korean Multicenter CTO CT Registry Score as a Tool for Assessing Difficulty in Chronic Total Occlusion Percutaneous Coronary Intervention. Catheter Cardiovasc Interv. Department of Cardiology and Cardiovascular Interventions, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland; 19. Prog Cardiovasc Dis. coronary occlusion; methods; outcome; percutaneous coronary intervention; treatment. Lutherplatz 40 47805 Krefeld Anfahrt Tel: 02151 32-0 Fax: 02151 32-20 40 info.krefeld@helios-gesundheit.de Unser Angebot; Ihr Aufenthalt; Unser Haus; HELIOS Hotline 0800-Medizin. Einige Cookies von "Kliniken.de" sind für die Kernfunktionalitäten der Seiten erforderlich. Kuriyama N, Kobayashi Y, Yamaguchi M, Shibata Y. B) A polymer-jacketed guidewire is inserted into the microdissections created over a microcatheter. Use of CCTA in patients with CTO is limited by issues relating to patient radiation exposure and reimbursement costs. So muss z. Unsere Experten der Angiologie im Helios Klinikum Krefeld beraten und behandeln Sie umfassend bei Erkrankungen der Arterien, Venen und Lymphgefäße. Structural Interventional Cardiology, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy. Table 2. 2016;28:E37-41. Hoffmann U, Ferencik M, Cury RC, Pena AJ. 14. 2018;11:127-42. Krefeld 03.04.2019 Anna Prenner | Marina Dorsch. Prof. Dr. Zilkens ist operativ am Johanna Etienne Krankenhaus in Neuss, in der ATOS Orthoparc Klinik in Köln und der Helios Klinik in Krefeld Hüls tätig. A) Troubleshooting options in case of an impenetrable proximal CTO cap: use of progressively stiffer guidewires; enhanced support; move-the-cap techniques (i.e., extraplaque entry proximal to the CTO lesion, resulting in extraplaque bypassing of the proximal CTO cap); the Carlino technique (selective microinjections of small amounts of contrast to disrupt the proximal CTO cap); intravascular lithotripsy; and retrograde-based strategies. Federal government websites often end in .gov or .mil. In cases of superficial, concentric calcification (intraplaque tracking), several alternatives are available to adequately prepare the lesion and allow balloon expansion: rotational/orbital atherectomy, cutting/scoring/high/very high pressure balloon dilatation, as well as intravascular lithotripsy (IVL). Alexander Bufe? K.Mashayekhi received consultancy fees and speaker honoraria from Abbott, Abiomed, Asahi Intecc, AstraZeneca, Biotronik, Boston Scientific, Cardinal Health, Daiichi Sankyo, Medtronic, Shockwave, Teleflex, and Terumo. Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland; 20. Dr. Shin) Unsere Sprechzeiten und Ambulanzen. Iwai S, Watanabe M, Okamura A, Kyodo A, Nogi K, Kamon D, Hashimoto Y, Ueda T, Soeda T, Okura H, Saito Y. Prognostic Impact of Calcified Plaque Morphology After Drug Eluting Stent Implantation- An Optical Coherence Tomography Study. Of note, extraplaque techniques can also be used to resolve the problem of uncrossable caps or lesions. Albrecht D, Kaspers S, Fussl R, Hopp HW, Sechtem U. Coronary plaque morphology affects stent deployment: assessment by intracoronary ultrasound. Ghoshhajra BB, Takx RAP, Stone LL, Girard EE, Brilakis ES, Lombardi WL, Yeh RW, Jaffer FA. Facharzt für Innere Medizin Helios Klinikum Krefeld Medizinische Klinik I Lutherplatz 40 47805 Krefeld Jetzt auf Karte Ansehen Versicherungsart: Alle Sprachen: Sie sind PD Dr. med. Finally, rotational/orbital atherectomy can be used to prepare calcified lesions, once the intraplaque tracking is confirmed by IVUS. Coronary computed tomographic prediction rule for time-efficient guidewire crossing through chronic total occlusion: insights from the CT-RECTOR multicenter registry (Computed Tomography Registry of Chronic Total Occlusion Revascularization). Eccentric calcification can be more problematic to treat, particularly when extraplaque tracking occurs; in the latter case, aggressive balloon dilatation or application of other techniques can cause severe vascular trauma that can be very difficult to control, therefore we recommend not using very high dilatation pressures (<14 atm). Antegrade wiring, antegrade dissection and reentry, and the retrograde approach are all complementary and necessary crossing strategies. In a multicentre series of patients treated with CTO PCI, device-uncrossable lesions were found in 9% of cases34; importantly, moderate/severe calcification was significantly more frequent (82% vs 52%), suggesting an important association between heavy calcification and the presence of device-uncrossable lesions. : 08.30 am to 03.00 pm), - Transcatheter aortic valve implantation (TAVI), Chief Physician at Helios Hospital Krefeld, «Recanalisation of chronic total coronary occlusions. Unser Herz ist ein faszinierendes Organ, es bringt Höchstleistung im Dauereinsatz. §Evidence regarding orbital atherectomy is currently limited. JACC Cardiovasc Interv. CTO: chronic total occlusion; IVUS: intravascular ultrasound; PCI: percutaneous coronary intervention; RCA: right coronary artery. Use of Coronary Computed Tomographic Angiography to Facilitate Percutaneous Coronary Intervention of Chronic Total Occlusions. Kockx MM, De Meyer GR, Muhring J, Jacob W, Bult H, Herman AG. CABG: coronary artery bypass graft; CCTA: coronary computed tomography angiography; CTO: chronic total occlusion; LAD: left anterior descending coronary artery; LCx: left circumflex coronary artery; LIMA: left internal mammary artery. Unsere Kernkompetenz ist der Blick durchs Schlüsselloch. Herzlich Willkommen in der Medizinischen Klinik II. “Move the cap” technique for ambiguous or impenetrable proximal cap of coronary total occlusion. Harding SA, Wu EB, Lo S, Lim ST, Ge L, Chen JY, Quan J, Lee SW, Kao HL, Tsuchikane E. A New Algorithm for Crossing Chronic Total Occlusions From the Asia Pacific Chronic Total Occlusion Club. Helios Klinikum Krefeld Ihr Maximalversorger am Niederrhein. Elrayes MM, Xenogiannis I, Nikolakopoulos I, Vemmou E, Wollmuth J, Abi Rafeh N, Karmpaliotis D, Gasparini GL, Burke MN, Brilakis ES. Meine Leidenschaft ist die interventionelle Kardiologie. Meticulous attention to lesion preparation and stenting technique, often requiring intracoronary imaging, is required to ensure optimum stent expansion and minimize the risk of short- and long-term adverse events. These intraprocedural difficulties can potentially have a detrimental impact on patient prognosis, since poor stent expansion is a major predictor of stent thrombosis and restenosis34. Ende 2007 wechselte er vom Universitätsklinikum. Ihre Auswahl können Sie jederzeit über den Link "Datenschutz-Einstellungen" im Footer ändern. Impressum 18. Wir widmen uns einem sensiblen Bereich Ihres Körpers mit ebenso sanften, minimalinvasiven Methoden und individuellen Therapien – in jedem Lebensalter. 2016;87:742-8. Division of Cardiology and Angiology II, University Heartcenter Freiburg - Bad Krozingen, Bad Krozingen, Germany. Accordingly, percutaneous revascularisation techniques can be adapted to the calcium distribution determined by CCTA. Hospital Clinico San Carlos IDISSC, Complutense University of Madrid, Madrid, Spain; 17. Use of Intravascular Imaging During Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry. On the contrary, severe calcification emerges as an important component of the European CTO (Euro CTO) score, which was derived from the largest dataset currently available (14,882 patients). Outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) have improved because of advancements in equipment and techniques. In addition, even after a successful wire crossing, advancing balloons and deploying stents can become challenging. However, caution is advised, as perforations have been previously described41. Prof. Dr. Med. 32. 2022;99:497-501. J Am Coll Cardiol. Dr. Alexander Bufe Chefarzt der Kardiologie und konservativen Intensivmedizin am Helios Herzzentrum Niederrhein. S.A.Pyxaras reports proctorship and consultancy fees from Asahi Intecc and Boston Scientific; and speaker honoraria from Abiomed, AstraZeneca, and BIOTRONIK. Atherosklerotische Herzkrankheit: Drei-Gefäß-Erkrankung [I25.13], Akuter subendokardialer Myokardinfarkt [I21.4], Atherosklerotische Herzkrankheit: Stenose des linken Hauptstammes [I25.14], Aortenklappenstenose mit Insuffizienz [I35.2], Anpassung und Handhabung eines implantierten Herzschrittmachers [Z45.00], Anpassung und Handhabung eines implantierten Kardiodefibrillators [Z45.01], Atrioventrikulärer Block 3. Alle optionalen Cookies akzeptieren The role of coronary computed tomography angiography in the assessment of a heavily calcified chronic total occlusion. Lutherplatz 40 47805 Krefeld Nordrhein-Westfalen Zur Homepage der Klinik 630 von 821 Nutzern würden diese Klinik empfehlen Gesamtzufriedenheit Qualität der Beratung Medizinische Behandlung Verwaltung und Abläufe Ausstattung und Gestaltung Eigene Bewertung abgeben Erfahrungsberichte (833) Anfragen (0) Die Klinik stellt sich vor 833 Bewertungen B. die Anmeldung eines Benutzers (pro Sitzung) gespeichert werden oder es werden für eine vereinfachte Suchabfrage die Suchparameter im Browser abgelegt. Department of Cardiology, Memorial Bahcelievler Hospital, Istanbul, Turkey; 7. Michael Friedrich (* 1966 in Wadern) ist ein deutscher Gynäkologe, Professor und Direktor der Klinik für Frauenheilkunde und Geburtshilfe am Helios Klinikum Krefeld. This scenario implies bypassing the heavily calcified plaque of the CTO segment by tracking the extraplaque space33. Hinweis zu Cookies. 5. aufklappen zuklappen Ausgewählte Filter Noch keine Filter ausgewählt; aufklappen zuklappen Treffer Soziale Netze 1; Web 173; Gesamt 174; aufklappen zuklappen Quellen Wikipedia 118.
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