Intracoronary Fibrin-Specific Thrombolytic Infusion Facilitates Percutaneous Recanalization of Chronic Total Occlusion
Amr E. Abbas, MD,
Stacy D. Brewington, MD,
Simon R. Dixon, MBChB,
Judith A. Boura, MS,
Cindy L. Grines, MD, FACC and
William W. O’Neill, MD, FACC*
William Beaumont Hospital, Royal Oak, Michigan
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Figure 1 An angiogram (left) showing a guiding catheter situated in the right coronary artery. A guidewire is advanced in the vessel and a 3-F Ultrafuse-X catheter is advanced to the site of occlusion. The guiding catheter and Ultrafuse-X catheter (right) are sutured to the skin and covered in a sterile fashion.
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Figure 2 Multivariate predictors of successful recanalization of chronic total occlusion with intracoronary lytic therapy infusion in patients with previous failed attempts. CI = confidence interval.
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Figure 3 Angiographic images before (left) and after (right) percutaneous coronary intervention of the chronic total occlusion of the right coronary artery. The chronic total occlusion angiographic characteristics include tapering, lack of bridging collaterals and side branch at the area of occlusion, proximal location, and no calcification. A total of three drug-eluting stents were implanted in an overlapping fashion from distal to proximal (3.5 x 33, 3.5 x 33, and 3.5 x 23) and a 4.0 non-compliant balloon was used for further expansion of the proximal stent.
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